Prevalência de disfunção sexual na acromegalia e correlação com fatores prognósticos

Abstract

Acromegaly is a chronic, slow and progressive disease resulting from increased release of growth hormone (GH) and insulin-like growth factor I (IGF 1). Patients having this condition presented several comorbidities, including endocrine-metabolic alterations. In this context, studying sexual dysfunctions, especially erectile dysfunction (ED), as well as the worsening quality of life resulting from these comorbidities, is of paramount importance.Objective: To evaluate the prevalence of hypogonadism and sexual dysfunction in patients with acromegaly and to correlate it with prognostic factors. Methodology: This is a cross-sectional study carried out from October 2020 to August 2021. 20 male patients attended at the Walter Cantídio University Hospital (HUWC) participated. As data collected instruments we used: participation form; follow-up sheet; questionnaires to assess sexual function International Index of Erectile Function (IIFE) and quality of life (Acro-Qol),in addition to biochemical and hormonal dosages.Results: The patients had a mean age of 49 ± 10 years. Most (16;80,0%) reported some comorbidity, with hypertension being the most reported (65,0%).When assessing sexual function, 65.0% of patients with acromegaly (13) had some type of ED. These had a higher mean age when compared to the group without ED (p=0.039). Regarding the IIFE domains, all scores were higher among patients without ED, with emphasis on orgasmic function (p=0.006) and satisfaction with sexual intercourse (p=0.007). Regarding laboratory measurements, we did not obtain significant results between the two groups (with and without ED) the same occurred when we compared disease control (p=0.642). By correlating the variables, it was observed that age was inversely related to sexual desire (R=-0.5, p=0.032). And a moderate correlation between free T4 levels and satisfaction with sexual intercourse (R=0.64, p=0.0046), however, FT4 levels showed a weak negative correlation with ED (r=-0 .47, p=0.005). Conclusion: That erectile dysfunction occurred in most patients with acromegaly. When evaluating sexual parameters, an inverse relationship with age and a direct relationship with FT4 levels was observed. Furthermore, the sexual parameters were not directly related to the analyzed hormones. Thus, new studies in different centers are needed to evaluate factors related to erectile dysfunction in this population.