Basic Mechanisms of Development, Diagnosis and Treatment of Acromegaly

Acromegaly is a serious disorder caused by excess production of somatotropic hormone (STH) due to pituitary tumour. This leads to increased production of insulin-like growth factor 1 (IGF-1) by the liver, resulting in tissue effects of STH. Tumour size plays a role in hormone control, with larger tumours responding worse to treatment. In about 70-80% of patients with acromegaly, the tumour extends beyond the Turkish saddle, making treatment more difficult. Excess production of STH and IGF-1 has deleterious effects on the body, affecting systemic, metabolic and potentially leading to neoplastic consequences. These factors contribute to reduced life expectancy and mortality, which is 2-3 times higher in patients with acromegaly.