Original Article

, Volume: 15( 2)

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Comparative Study of Aromatase Activity Level in Male Patients with Active Acromegaly

*Correspondence:

Iqbal Hanash DheferChemistry Department, College of Science, Al-Mustansiriya University, Iraq
Tel:+9645664158401416;E-mail: [email protected]

Abstract

Aromatase activity in the acromegaly is a critical marker of decided sexual behavior. There is a confirmation demonstrated that aromatase activity is associated withtestosterone和雌二醇水平。目的是探索relationship between GH, IGF-1, testosterone, estradiol and aromatase activity in patients with active acromegaly. In this study sixty males (age 20-60) years were enrolled. Serum of testosterone, estradiol, GH, IGF-1 and aromatase activity measured in both groups. The results revealed that mean of serum aromatase activity and estradiol levels were significant differences decrease in active acromegaly when compare with the control group and aromatase activity important correlate with IGF-1 and estradiol necessary correlate with GH/ IGF-1 and T/E2. While GH, IGF-1-1, GH/ IGF-1,testosteroneand T/E2 were significant differences increase in active acromegaly when compare with the control group and GH was necessary to correlate with GH/IGF-1 in patients group.

Keywords

GH; Aromatase activity; Testosterone; E2; IGF-1; Active acromegaly

Introduction

Acromegaly is severe hormonal disorder and uncommon portrayed by progressive somatic deformation involving mainly face and extremities and from variantgrowth hormonesecretion and subsequent increment of IGF-I, most created by benign pituitary adenomas, and can characterized as a hormonal disorder that most typically happens in moderately aged men and women [1]。在诊断时,全身并发症s are also common, including cardiovascular, changes in the physical, gastrointestinal, endocrine and metabolic systems, catabolic states, renal failure, malnutrition, anddiabetes mellitus[1]。Excessivegrowth hormoneproduction in children can prompt to gigantism, and in adults, it can prompt to acromegaly. Various variables are known to influence GH secretion, such as sex, diet, age, stress, exercise, and otherhormones[2]。Lack of sleep suppresses GH release, especially after early adulthood [3]。An increase of GH secretion causes the liver to produce more than the usual amount of (IGF-I). Then this new IGF-I that causes the growth of the organs and soft tissues and swelling. A successive result of acromegaly is developed a web-based acromegaly patient registry and utilized it to demonstrate that hypogonadism, even in male patients with microadenomas, who are not at hazard fromhypopituitarismbecause of local mass impacts. Additionally, showed that hypersecretion ofprolactinand GH contribute to thepathogenesisofhypogonadismin acromegaly and that may happen in macroadenoma patients even without of hyperprolactinemia [4]。

Aromatase is the enzyme that’s consid r d as a rat -limiting in the conversion of androgens intoestrogensand is an individual from the P450 cytochrome superfamily. Through successive cytochrome P450-catalyzedoxidations the one central pathway that convertsprogesteroneto its derivative (17-hydroxy, 17-hydroxyprogesterone, and th n to Δ4-androstenedione) [5]。h aromatas活动Δ4-androstenedione created estrone, and activity of a dehydrogenase on this gives the main compound, 17 β- stradio . Inst ad, Δ4-androstenedione can be converted into theandrogenand then into testosterone, which can b transform d straightforward y into 17β-estradiol [6]。Factors knew to increment aromatase activity incorporate age, insulin, weight, liquor and gonadotropins. Diminished aromatase activity is by an anti-Müllerian hormone, prolactin. Its shows to be Strengthen in particular estrogen-dependent local tissue next to endometrial cancer, endometriosis, uterine fibroids and breast tissue [7]。

Likewise, sometimes alluded to as familial gynecomastia or familial hyper estrogenism, is an endocrine syndrome and rare hereditary which is featuring by aromatase overexpression, thus resulting in excessive levels of circulatingestrogens[8]。Physiological observed variations of the condition include overexpression of aromatase and, accordingly, excessiveestrogenslevels including estradiol and estrone, and the greater rate of peripheral conversion of androgens toestrogens[7]。The goal of this study was to estimate the variant in the aromatase activity levels in acromegaly patients compare with control and some related parameters, GH, IGF,Testosteronehormone, estradiolhormoneand whether aromatase level can potential use to follow up the active acromegaly patients.

Patients and Methods

In this study sixty males (age 20-60) years were registered, (30) active acromegaly patients who have attended the National Diabetes Center and Specialist Center for endocrinology and diabetes, Baghdad for the period from month (12/2015) to month 6/2016) and healthy as a control group. Since physicians diagnosed all patients. Blood was collected, and the sera were separated. GH, IGF-1 and levels of aromatase activity estimated by (ELISA) enzyme-linked immune sorbent assay kits. Mini Viduse is used for hormonalTestosteroneand estradiolhormonesinvestigations for all the patients and control. The principle test combines a final fluorescent detection with an enzyme immunoassay sandwich method (ELFA). All steps of the assay are achieved automatically by the instrument VIDAS^®estradiol, VIDAS^®Testosterone. BMI was determined by used this equation (BMI)=mass (kg)/(height)²(m²).

Statistical analysis

Statistical analyses were done using SPSS program version 19 which includes: Mean ± standard deviation, independent t-test, P-value equal or less than 0.05 be considered significant, w us d P arson’s Corr ation coefficient to test between (aromatase activity) and different parameters.

Discussion and Results

Mean ± SD of IGF-1, GH, ratio of GH to IGF-1 and BMI for active acromegaly patients and control were seen inTable 1was manifested that: In patients with active acromegaly the mean of GH, IGF-1 and ratio of GH to IGF-1 were significant differences greater than control group, while BMI was non-significant differences and greater than the control.Table 2showed that mean of testosterone, estradiol and ratio oftestosteroneto estradiol were a higher significant difference in patients with active acromegaly when contrasted with the control group.

Table 1.Mean ± SD of GH, GH/ IGF-1, IGF-1 and BMI.

Table 2.Mean ± SD of Testosterone, Estradiol and Testosterone/Estradiol.

Table 3showed that mean of aromatase activity was a significant difference greater in patients with active acromegaly when contrasted with healthy control group.

Table 3.Mean ± SD of Aromatase activity.

Table 4demonstrated the correlation between GH and (GH/IGF-1) positively significant difference in active acromegaly patients in male patients with acromegaly keeps that significant negative correlation between IGF-1 and (GH/IGF-1) and positive correlation with aromatase activity. GH/ IGF-1 was a positive correlation with estradiol while its negative correlation with Testosterone/Estradiol.

Table 4.Correlation between parameters for male active acromegaly patients.

In this study, we determined aromatase activity and somehormonessuch as testosterone, estradiol and some parameters such as IGF-1, GH and BMI in Iraqi active acromegaly patients and compared with control group. Serum GH level was very highly significant increase (P ≥ 0.0000) was seen in this study in active acromegaly patients when contrasted with control groups. Acromegaly disorders created by increased secretion ofgrowth hormoneon account of tumour in the pituitary. GH activities anabolic on numerous organs systems very much recorded. GH invigorates bone growth during the childhood, and its induces skeletal maturation during early adulthood andadolescence[9]。Most investigate, for example, the outcome which acquired by Johan et al. [10]。In this study found the GH stimulates longitudinal bone growth andbody mass indexand expanded in patients with acromegaly, because of positively correlated with the body weight with bone mineral density ,the obese is not the reason, The outcome in our study is conformity with the outcome which acquired by Reid [11看到尤其)是证明差异both acromegaly and healthy control group and no variance particularly active acromegaly and control, but the result was dispute with the outcome acquired via Berg et al. [12] who demonstrated that no significant variance when contrasted with levels of physiological.

在目前的研究中被认为血清igf - 1标准l was very highly significant (P=0.0000) in patients with active acromegaly when compared with control groups, due to GH secretion by the pituitary into the circulation that's motivated to make anotherhormonecalled insulin-like growth factor-I from the liver then lead to tissue growth in the body. Elevated levels of IGF-I, similar to this, signal the pituitary to decrease GH generation. If the pituitary continues to make GH-independent of the conventional regulatory mechanisms, the level of IGF-I continues rising, stimulated to bone overgrowth and organ enlargement. Furthermore, also in the present study was seen increase significant increment of level GH/IGF-1 (P ≥ 0.0000) in serum patients with active acromegaly when contrasted control groups, the result in our study is inter alia with the outcomes acquired via Julie Silverstein [13] proposes that the utilization of the last available values for GH/IGF1 assessments, which have invariably utilized in most clinical studies, may not accurately estimate mortality hazard in patients with acromegaly.

A very highly significant increment of serumtestosteroneand the ratio levels (P=0.0000) and the significant decrease of serum estradiol (p=0.0000) were seen in this study in patients with active acromegaly when contrasted with control groups. Other than making a healthier person, inhibiting aromatase creation will also apparently incrementtestosteronelevels because lesstestosteronewill be converted intoestrogen[14]。Testosterone/estrogen ratio controlled by the activity of aromatase and intracellular presented. The testosterone/estrogen proportion has been seemed to essential forapoptosisof the oocytes and the induction of ovulation [15,16]。From the clinical studies was discoveries on theestrogendeficiency significance in men [17,18] the actions ofestrogenand its necessity in males also has turned into an acknowledged idea these days [19,20]。

A very highly significant decrease of serum aromatase activity levels (P=0.0000) The outcome of our review is concurrence with the findings got by Morishima and Sudeep [21,22] demonstrates the 28 years old XX, followed since childhood, showed the essential elements of the aromatase deficiency syndrome as newly characterized. The patient atbirthhad no adrenal female pseudo hermaphrodism and undergone reform of the external genitalia, such as a clitorectomy. Since at the puberty, created following indications of pubertal failure, virilization without anyestrogenaction signs, hypogonadotropic polycysticovariesandhypogonadismlead to increase the plasma androstenedione concentrations, 17-hydroxyprogesterone and testosterone, whilelowplasma of estradiol. Polycysticovariesthat a strikingly unusual proportion oftestosteroneand androstenedione to estrone and estradiol.Hormonesurrogate therapy prompted to menses, breast development, determination the growths of ovarian, and extinction of the increased LH and FSH amounts. Regulate the P450 arom gene by tissue-specific promoters at the levels of transcriptional in the brain, adipose tissues, placenta, gonads [23,24] the authors control of aromatasegene expressionnot just for the breastcancer treatment[25], additionally in males, for example, in the instances of gynecomastia [26,27] or prostate cancers [28]。The outcome of our study is agreement with the results acquired by that suggested aromatase blockade brought about a fall in E2 with a with a relating increment in T levels [29]。

Conclusion

There is significant association between levels of (GH/ IGF-1) with GH in active acromegaly patients. While (GH/ IGF-1) is negatively significantly association with IGF-1. Positively associated with aromatase activity with IGF-1in patients with acromegaly. Estradiol is positively significantly association with (GH/IGF-1) while it's negatively significantly association with T/E2. Aromatase activity can play a role toestrogenlevel in patients with acromegaly.

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