Uric acid levels correlate with disease activity in growth hormone-secreting pituitary adenoma patients

Abstract

Objective: Few studies reported the effects of growth hormone-secreting pituitary adenoma (GHPA) on uric acid (UA) metabolism and the relationship between growth hormone (GH)/insulin-like growth factor-1 (IGF-1) levels and UA are controversial. This study aimed to evaluate the relationship between IGF-1 and UA in patients with GHPA and to further clarify whether UA levels are associated with GHPA disease activity by follow-up.

Methods: A longitudinal study of 424 GHPA patients presenting to Beijing Tiantan Hospital, Capital Medical University between January 2015 and January 2023 was conducted. Spearman's correlation tests were performed to examine the relationship between IGF-1 and UA at baseline. Univariate and multivariate linear regression analysis was conducted to investigate the independent association between UA and IGF-1. Changes in postoperative IGF-1 and UA levels were followed prospectively, and the differences in UA levels between the biochemical remission and nonremission groups were compared.

Results: At baseline, male patients, the lower the age, the higher the IGF-1 and body mass index (BMI), and the higher the UA levels. IGF-1 was significantly associated with UA after controlling for sex, age, and BMI (r = 0.122, P = 0.012). In adjusted multiple linear regression analysis, IGF-1 was independently associated with UA, and UA levels increased significantly with increasing IGF-1. During postoperative follow-up, UA decreased gradually as IGF-1 levels decreased. At 12 months postoperatively, UA levels were significantly lower in the biochemical remission group than in the nonremission group (P = 0.038).

Conclusions: In patients with GHPA, UA levels are associated with disease activity. Changes in UA levels should be taken into account in the comprehensive treatment of GHPA, patients presenting with HUA should be given lifestyle guidance and appropriate urate-lowering treatment according to their condition to better improve their prognosis.

Keywords: disease activity; growth hormone; growth hormone-secreting pituitary adenoma; insulin-like growth factor-1; uric acid.

Figure 1

Postoperative changes in IGF-1 (A), UA (B), TP (C), BUN (D), Cr (E), and eGFR (F) levels. IGF-1, insulin-like growth factor-1; UA, uric acid; TP, total protein; BUN, blood urea nitrogen; Cr, creatinine; eGFR, estimated glomerular filtration rate; ****P values < 0.0001; ***P values < 0.001; **P values < 0.01; *P values < 0.05; n.s., not significant.

Figure 2

Differences in UA levels between the biochemical remission and nonremission groups at 3 months (A), 6 months (B), and 12 months (C) postoperatively and the relationship between biochemical remission rates and UA levels (D). UA, uric acid; n.s., not significant; *P values < 0.05.