1. Long-term facial changes and clinical correlations in patients with treated acromegaly: a cohort study
- Author
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Lu Gao, Xiao Long, Xiaojun Wang, Qiao Chen, Zihao Wang, Bing Xing, Xiaopeng Guo, and Fengzhou Du
- Subjects
Adenoma ,Adult ,Male ,China ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Urology ,030209 endocrinology & metabolism ,Nose ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Acromegaly ,medicine ,Humans ,Pituitary Neoplasms ,Insulin-Like Growth Factor I ,Young adult ,Aged ,Human Growth Hormone ,business.industry ,Remission Induction ,Confounding ,Soft tissue ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Face ,030220 oncology & carcinogenesis ,Female ,business ,Follow-Up Studies ,Hormone ,Cohort study - Abstract
Background Facial abnormality is the most significant feature in acromegaly patients. However, it is unclear whether and how patient facial appearance improves after treatment. This study aimed to identify 3D facial changes in acromegaly patients after surgical treatment. Methods This study included 30 acromegaly patients who underwent resection of a pituitary GH adenoma. The location and extent of facial changes were identified by comparing baseline and 2-year follow-up 3D images of the face. Relationships between facial changes and GH and IGF-1 were evaluated with simple or multivariable linear regression models. Results Significant soft tissue improvements were observed in acromegaly patients with complete remission, especially in the nose and lip region. Significant reductions in nasal width (3.46 mm, P < 0.001), tip protrusion (1.18 mm, P = 0.003), face curve length (3.89 mm, P = 0.004) and vermilion area (1.42 cm3, P = 0.001) were observed at the 2-year follow-up. Further, changes in nasal width were associated with decreases in GH (β = 4.440, P = 0.017), the GH nadir (β = 4.393, P = 0.011) and IGF-1 (β = 5.263, P = 0.002). The associations were maintained after adjusting for confounders. Conclusions Acromegaly patients achieved considerable facial improvements after surgical treatment. The change in nose width was associated with GH and IGF-1 decrease. Better control of patient hormone levels after surgery improves patient facial recovery.
- Published
- 2021
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