What are the features of acromegaly largely attributed to?

The features of acromegaly are largely attributed to excess growth hormone. This condition typically arises from a benign tumor in the pituitary gland known as an adenoma, which leads to the overproduction of growth hormone. The excess growth hormone causes an increase in the levels of insulin-like growth factor 1 (IGF-1), resulting in the abnormal growth of various tissues and organs.

Patients with acromegaly exhibit characteristic physical changes, such as enlarged hands and feet, facial changes including a protruding jaw, and thickened skin. Additionally, the condition can lead to metabolic disturbances and increased risk of cardiovascular disease due to the influence of growth hormone on various bodily systems.

The other options mentioned do not directly relate to the pathophysiology of acromegaly. Vitamin D deficiency primarily affects bone health and calcium metabolism, thyroid hormone imbalance relates to various metabolic disorders, and insulin resistance is a feature commonly associated with conditions such as type 2 diabetes but is not the direct cause of the signs and symptoms of acromegaly. By focusing on the role of excess growth hormone, one can understand the distinct growth changes and associated risks linked to this endocrine disorder.