Preoperative and postoperative blood testosterone levels in patients with acromegaly: a prospective study

Duoxing Zhang; Xiaopeng Guo; Ming Feng; Xinjie Bao; Kan Deng; Yong Yao; Wei Lian; Bing Xing; Hanbi Wang

doi:10.3389/fendo.2023.1259529

Preoperative and postoperative blood testosterone levels in patients with acromegaly: a prospective study

Front Endocrinol (Lausanne). 2023 Oct 11:14:1259529. doi: 10.3389/fendo.2023.1259529. eCollection 2023.

Authors

Duoxing Zhang^{1

2}, Xiaopeng Guo^{1

3}, Ming Feng^{1

3}, Xinjie Bao^{1

3}, Kan Deng^{1

3}, Yong Yao^{1

3}, Wei Lian^{1

3}, Bing Xing^{1

3}, Hanbi Wang⁴

Affiliations

¹ Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Key Laboratory of Endocrinology, China Pituitary Adenoma Specialist Council, Beijing, China.
⁴ Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.

Abstract

Purpose: To investigate the prevalence of low blood testosterone level (LTL) and its determinant factors among active male acromegaly patients, as well as the effect of surgery on LTL in male acromegaly patients.

Methods: A retrospective, single-center study focused on 252 male acromegaly patients aged 18 years-60 years diagnosed in the Peking Union Medical College Hospital from January 2015 to December 2018 was carried out. The measurements of preoperative and postoperative testosterone levels, serum growth hormone (GH), insulin-like growth factor 1 (IGF-1), and other clinical data were analyzed.

Results: Forty per cent of subjects included were diagnosed with LTL pre surgery. Patients were divided into normal testosterone level (NTL) and LTL groups based on their testosterone level. There were significant differences (p < 0.01) between groups in the presence of macroadenomas, invasion of the cavernous sinus, compression of the optic chiasm, and serum GH and prolactin levels pre surgery. Invasion of the cavernous sinus [odds ratio (OR) = 4.299; p = 0.000] and serum prolactin level (OR = 1.023, p = 0.001) were independent predictors of LTLs in male patients before surgical intervention. A total of 67.9% of LTL patients recovered during the follow-up, with a new-onset rate of 3.4%. Body mass index, invasion of the cavernous sinus, GH, IGF-1, and prolactin levels, the presence of a prolactin-secreting tumor, and recovery from acromegaly were significantly different (p < 0.05) in the NTL group and in the LTL group during the follow-up. The presence of a prolactin-secreting tumor (OR = 0.224; p = 0.001) and recovery from acromegaly (OR = 0.168; p = 0.006) were independent predictors of LTLs in male acromegaly patients during the follow-up.

Conclusion: The invasiveness of tumor and levels of blood prolactin are independent factors for LTLs before surgery, whereas GH and IGF-1 levels are not. Most male patients can recover from LTL after tumor restriction surgery: those who recover from acromegaly have a better chance of recovering from LTL.

Keywords: GH; acromegaly; low blood testosterone level; male; surgery intervention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acromegaly* / surgery
Humans
Insulin-Like Growth Factor I / metabolism
Male
Pituitary Neoplasms* / pathology
Prolactin
Prospective Studies
Retrospective Studies
Testosterone

Substances

Insulin-Like Growth Factor I
Prolactin
Testosterone

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-114), and the Fundamental Research Funds for the Central Universities (3332022009).