THU067 Long-term Depot Specific Changes In Adipose Tissue After Treatment Of Acromegaly
Authors: Falch Camilla Maria , Godang Kristin , Lekva Tove , Heck Ansgar , Bollerslev Jens , Olarescu Nicoleta Cristina 
Published: October 2023

Abstract
Disclosure: C.M. Falch: Speaker; Self; Pfizer, Inc. K. Godang: None. T. Lekva: None. A. Heck: Speaker; Self; Ipsen, Recordati. J. Bollerslev: Advisory Board Member; Self; Pfizer, Inc. Speaker; Self; Ipsen, Pfizer, Inc. N.C. Olarescu: Speaker; Self; Pfizer, Inc., CORE2ED.
Objective: Patients with active acromegaly present a decreased adipose tissue (AT) mass, and short-term studies show that the AT increases following treatment. However, it remains unclear if the increase is persistent in the long-term perspective. Aim: To characterize the depot specific changes of AT after treatment of acromegaly and identify contributing factors. Methods: In a clinically well-defined cohort of patients with acromegaly (n = 62), visceral (VAT), subcutaneous (SAT), total (TAT) adipose tissue, and android to gynoid ratio (A/G ratio) were measured by Dual Energy X-ray Absorptiometry (DXA). Measurements were assessed at diagnosis, and at a short- and long-term visit (median follow-up time (IQR): 1.9 (1.5-2.3) and 5.5 (3.6-9.6) years, respectively). Growth hormone (GH), insulin-like growth factor I (IGF-I), glucose and HbA1c levels, gonadal status, and the presence of diabetes mellitus were recorded prospectively. Remission status was assessed at the long-term visit (IGF-I ≤ 1.3 x ULN). Comparison between time points was performed using paired t-test or Mann-Whitney U test depending on distribution, and chi-square test for categorical variables. Differences in the temporal course were evaluated by mixed model analyses, adjusted for age. Results: VAT and A/G ratio increased at both time points, whereas SAT and TAT mainly increased at short-term, plateauing afterwards (p &lt; 0.05 for all). VAT and A/G ratio were higher in men (p = 0.035 and p &lt; 0.001), and the A/G ratio increased more compared to women (p = 0.003). BMI remained stable. Glucose and HbA1c decreased at short-term (p &lt; 0.05) and remained stable at long-term, with no obvious sex differences. The gonadal status had no effect on the increase in AT in women. The increase in VAT (p = 0.046), but not SAT, TAT or A/G ratio, was more pronounced in patients with diabetes mellitus. The increase in AT strongly correlated with the decrease in GH (SAT (R = -0.48), TAT (R = -0.51), p &lt; 0.001 for both) and IGF-I (VAT (R = -0.28, p = 0.036), SAT (R = -0.27, p = 0.046), TAT (R = -0.26, p = 0.048) at long-term. The decrease in glucose correlated with the decrease in HbA1c (R = 0.38, p = 0.009) and IGF-I (R = 0.32, p = 0.014) at long-term. Remission status had no effect on changes in AT mass during follow-up. Conclusion: Treatment of acromegaly leads to an increase in AT mass in a depot and sex specific manner both at short-term and long-term follow-up. Glucose metabolism improves rapidly after disease control and persists, whereas patients with diabetes mellitus have a higher VAT increase that may worsen their long-term metabolic outcome.
Presentation: Thursday, June 15, 2023