Assessment of the condition of the salivary glands using ultrasound in patients with acromegaly

Acromegaly is a chronic neuroendocrine disease caused by prolonged hypersecretion of growth hormone and insulin-like growth factor-1 and leading to systemic soft tissue hypertrophy, while the condition of the salivary glands has not been sufficiently explored. The purpose of the study was to compare the size of the submandibular salivary glands according to ultrasound data in patients with active acromegaly and in healthy individuals of comparable age and gender, and to identify clinical and biochemical factors associated with the volume of the glands. A prospective comparative study included 27 patients with active acromegaly and 26 healthy volunteers. All underwent an ultrasound examination of the submandibular glands, measuring the length, width, and thickness of each gland and calculating the volume. The age, duration of symptoms, index of insulin-like growth factor-1, and presence of hyperprolactinaemia and echostructure of parenchyma were additionally assessed in patients. In patients with acromegaly, the median volume of the right gland was higher than in healthy subjects (10.0 versus 6.3 cm³), as was the volume of the left (8.8 versus 7.0 cm³; p < 0.01 for both), with a significant increase in length and width and no differences in thickness. Gland volume was negatively associated with age and duration of symptoms, was higher in men, and tended to decrease in hyperprolactinaemia; male gender, and duration of symptoms turned out to be independent predictors of volume. Acromegaly was accompanied by marked hypertrophy of the submandibular salivary glands, mainly due to an increase in length and width, which allows considering ultrasound evaluation of these glands as an additional non-invasive marker of the tissue response in acromegaly