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Neuroendocrinology and Pituitary

SAT-030 - Thyroid Abnormalities in Acromegaly in the Era of Improved Disease Control: A Two-Stage Study

Saturday, June 13, 2026
9:30 AM - 4:30 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Roberto Salvatori, MD: • Chiesi Global Rare Diseases: Advisory Board (); Camurus: Advisory Board (); Crinetics: Advisory Board ()


Purpose: Acromegaly is associated with increased risk of diffuse or nodular goiter and
possibly thyroid cancer. The aim of this study was to verify whether these findings
persist in the current scenario of greater availability of somatostatin agonists and GH
receptor antagonists.

Methods: A two-steps protocol was carried out: the first retrospective, and the second
cross-sectional. In the first, clinical-and laboratory data (including 969 IGF-I
measurements), and the frequency of thyroid cancer were recorded for 92 acromegaly
patients over a 28-year period. Disease activity was defined as persistent when the ratio
between IGF-I measurements during the total follow-up period and the respective upper
limit of the age (IGF-I/ULN) was greater than 1, and good control rate was the average
for each year of follow-up. In the second step, 74 acromegaly patients underwent
thyroid ultrasound. Thyroid nodules were classified using ACR-TIRADS.. A two-stage
cluster analysis was performed, with the aim of grouping them into homogeneous
clusters .

Results: . Of the 92 patients, 71.7% were women and 81.5% had macroadenomas;
approximately 70% were considered to have inactive disease, with a median control rate
of 50%.. Four cases of thyroid cancer were recorded (4.3%), but only one of them had
active disease. Two-thirds of the 74 patients (evaluated by ultrasound) presented with
nodules, and 27% presented with diffuse goiter. There was a significant positive
correlation between the percentage of biochemical control rate and the follow-up
duration (r = 0.378; p = 0.001). In contrast, a negative trend correlation was observed
between thyroid volume and control percentage (p = 0.077). Three clusters were
identified: Cluster 1 (n=18; 83.3% female; median age 64 years), Cluster 2 (n=36;
100% female; median age 60 years), and Cluster 3 (n=20; 100% male; median age 52.5
years). Significant differences were observed between clusters regarding sex and
echotextural alterations (p < 0.0001 in both cases). Age, number of nodules, thyroid
volume and follow-up time were similar across clusters.
Conclusion. No inherent thyroid abnormalities were identified in a large cohort of
patients with acromegaly, as the frequency of diffuse thyroid hyperplasia, thyroid
nodules, and risk of thyroid malignancy were not impressive. Better control during
follow-up may attenuate thyroid manifestations in acromegaly

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*