Early Lung Function Abnormalities in Acromegaly A. Benfante 1 • A. Ciresi 2 • M. Bellia 3 • F. Cannizzaro 3 • V. Bellia 1 • C. Giordano 2 • N. Scichilone 1 Received: 10 December 2014 / Accepted: 4 March 2015 Ó Springer Science+Business Media New York 2015 Abstract Background Acromegaly is an insidious disorder caused by a pituitary growth hormone (GH)-secreting adenoma resulting in high circulating levels of GH and insulin-like growth factor I (IGF-I). Respiratory disorders are common complications in acromegaly, and can severely impact on quality of life, eventually affecting mortality. Objectives The present study aimed to explore structural and functional lung alterations of acromegalic subjects. Methods We enrolled 10 consecutive patients (M/F: 5/5) affected by acromegaly. In all patients, magnetic resonance imaging (MRI) revealed the presence of pituitary tumor. All patients underwent clinical, lung functional, biological, and radiological assessments. Ten healthy age-matched subjects also served as controls. Results No statistically significant differences in lung function were detected between acromegalic and healthy subjects (p C 0.05 for all analyses). However, the diffusing capacity for CO (TLCO) was significantly lower in the acromegalic group than in healthy subjects (TLCO% pre- dicted: 78.1 ± 16 vs. 90 ± 6 %, respectively, p = 0.04; KCO% predicted: 77 ± 16 vs. 93 ± 5 %, p = 0.02, re- spectively). None of the lung function parameters corre- lated with duration of the disease, or with inflammatory marker of the airways. In acromegalics, biological (exhaled NO concentrations) and imaging (total lung volume, TLV, and mean lung density, MLD) evaluations were within normal values. The TLV measured by HRCT was 3540 ± 1555 ml in acromegalics, and the MLD was -711 ± 73 HU. None of the lung functional, radiological, and biological findings correlated with GH or IGF-I levels, and no correlation was found with duration of disease. Conclusions In the current study, lung function evalua- tion allowed to detect early involvement of lung parenchyma, as assessed by TLCO and KCO, even in the absence of parenchymal density alterations of the lung by HRCT. These findings suggest to routinely include the carbon monoxide diffusing capacity in the lung function assessment for an early intervention in acromegaly. Keywords Imaging Á Lung function Á Acromegaly Á Diffusing capacity Abbreviations COPD Chronic obstructive pulmonary disease FENO Fractional exhaled nitric oxide FEV 1 Forced expiratory volume in the 1st second FVC Forced vital capacity GH Growth hormone HRCT High-resolution computed tomography HU Hounsfield unit IGF-I Insulin-like growth factor I KCO Carbon monoxide transfer coefficient LAV Low attenuation volume MRI Magnetic resonance imaging OGTT Oral glucose tolerance test Dr. Benfante and Ciresi equally contributed to the preparation of the manuscript. & N. Scichilone nicola.scichilone@unipa.it 1 Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Pneumologia, Universita ` degli Studi di Palermo, via Trabucco 180, 90146 Palermo, Italy 2 Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Endocrinologia, Universita ` degli Studi di Palermo, Palermo, Italy 3 Dipartimento di Biotecnologie e Medicina Legale, Sezione di Scienze Radiologiche, University of Palermo, Palermo, Italy 123 Lung DOI 10.1007/s00408-015-9710-1