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Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature280006
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Publication Type
Article
Date
Sep-2016
Author
Jakob Dal
Ulla Feldt-Rasmussen
Marianne Andersen
Lars Ø Kristensen
Peter Laurberg
Lars Pedersen
Olaf M Dekkers
Henrik Toft Sørensen
Jens Otto L Jørgensen
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Acromegaly - diagnosis - epidemiology
Adult
Aged
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology
Prevalence
Prognosis
Registries
Stroke - epidemiology
Abstract
Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study.
All incident cases of acromegaly in Denmark (1991-2010) were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10(6) person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used.
Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10(6) persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality.
(i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment.
PubMed ID
27280374 View in PubMed
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Emerging trends in the diagnosis and treatment of acromegaly in Canada.

https://arctichealth.org/en/permalink/ahliterature118580
Source
Clin Endocrinol (Oxf). 2013 Jul;79(1):79-85
Publication Type
Article
Date
Jul-2013
Author
Sophie Vallette
Shereen Ezzat
Constance Chik
Ehud Ur
Syed Ali Imran
Stan Van Uum
Juan Rivera
Gudrun Caspar-Bell
Omar Serri
Author Affiliation
CHUM, University of Montreal, Montreal, QC, Canada.
Source
Clin Endocrinol (Oxf). 2013 Jul;79(1):79-85
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Acromegaly - diagnosis - epidemiology - therapy
Adult
Canada - epidemiology
Comorbidity
Diabetes Mellitus - epidemiology - metabolism
Female
Follow-Up Studies
Humans
Hypertension - epidemiology
Insulin-Like Growth Factor I - metabolism
Logistic Models
Male
Middle Aged
Multivariate Analysis
Physician's Practice Patterns - trends
Retrospective Studies
Sleep Apnea Syndromes - epidemiology
Treatment Outcome
Abstract
To evaluate demographic data and quality of care of patients with acromegaly in Canada and their evolution over time and secondly, to evaluate predictors of co-morbidities and treatment outcomes.
Retrospective analyses of clinical, biochemical and treatment outcome data of 649 patients with acromegaly (males: 50·7%) followed from 1980 to 2010 (mean 10·2 years, SD 13·7) in eight tertiary care centres from six Canadian provinces.
In comparison to 1980-1994, the number of patients referred with acromegaly in the last 15 years was higher with female preponderance (52·8% vs 41·4%, P = 0·01) and an older age at diagnosis (46·4 ± 14 vs 41·3 ± 12 years, P 
PubMed ID
23190441 View in PubMed
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