TY - JOUR
T1 - Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Español de Acromegalia, REA)
AU - Mestrón, Antonio
AU - Webb, Susan M.
AU - Astorga, Ricardo
AU - Benito, Pedro
AU - Catalá, Miguel
AU - Gaztambide, Sonia
AU - Gómez, José Manuel
AU - Halperín, Irene
AU - Lucas-Morante, Tomás
AU - Moreno, Basilio
AU - Obiols, Gabriel
AU - de Pablos, Pedro
AU - Páramo, Concha
AU - Picó, Antonio
AU - Torres, Elena
AU - Varela, César
AU - Vázquez, José Antonio
AU - Zamora, Juana
AU - Albareda, Mercè
AU - Gilabert, Montserrat
AU - Sánchez-Covisa, Miguel Aguirre
AU - Alcaraz Tafalla, Marisol
AU - Alonso Troncoso, Isabel
AU - Álvarez Escolà, Cristina
AU - Andía Melero, Victor Manuel
AU - Arranz Martín, Alfonso
AU - Arribas Palomar, Luis
AU - Ballesteros Pomar, María
AU - Beitia Martín, Juan José
AU - López, Pedro Benito
AU - Bernabeu Morón, Ignacio
AU - Blanco Carrera, Concepción
AU - Blanco Samper, Benito
AU - Boronat Cortés, Mauro
AU - Carrera Santaliestra, Maria José
AU - Castillo López, Luis
AU - Cordero Diez, Ma del Mar
AU - Costilla Martín, Enrique
AU - Cózar León, Ma Victoria
AU - Cuatrecasas Cambra, Guillem
AU - De Luís Román, Daniel Antonio
AU - de Miguel Novoa, Ma Paz
AU - De Pablos Velasco, Pedro
AU - Del Pozo Picó, Carlos
AU - Diez Gómez, Juan José
AU - Díez Hernández, Alberto
AU - Duran Rodríguez-Hervada, Alejandra
AU - de Antonio, Isabel Esteva
AU - Fajardo Montañana, Carmen
AU - Forga Llenas, Lluís
AU - Fraile Saez, Ángel Luis
AU - Galvez Moreno, Ma Angeles
AU - García Centera, José Andrés
AU - Gargallo Fernández, Manuel
AU - Gavilán Villarejo, Inmaculada
AU - Gil del Álamo, Paloma
AU - Gilsanz Peral, Alberto
AU - Gippini Pérez, Antonio
AU - Gómez Balaguer, Marcelino
AU - Gómez, Luis Alberto
AU - Gorgojo Martínez, Juan José
AU - Guerrero Martínez, Eduardo
AU - Hernández Bayo, Juan Angel
AU - Hernández López, Antonio
AU - Iglesias, Pedro
AU - Illán Gómez, Fátima
AU - Jaunsolo Barranechea, Miguel Ángel
AU - Lecube Torelló, Albert
AU - Liante Peñambía, Gaspar
AU - López dela Torre Casares, Martin
AU - López Hernández, Elena
AU - López López, José
AU - López-Guzmán, Antonio
AU - Lucas Martín, Ana
AU - Marazuela Azpiroz, Mónica
AU - Marco Martínez, Amparo
AU - Marco Mur, Ángel Luis
AU - Martin Castillo, Fidel
AU - Martín González, Tomás
AU - Martínez Brocca, Maria Asunció
AU - Megia Colet, Ana
AU - Merino Torres, Juan Francisco
AU - Morales Gorría, Ma José
AU - Morales Perez, Francisco
AU - Murillo Sanchis, Jesús
AU - Muros de Fuentes, Ma Teresa
AU - Páramo Fernández, Concepción
AU - Pavón de Paz, Isabel
AU - Pazos Toral, Fernando
AU - Pérez Corral, Ma Begoña
AU - Pérez Pérez, Antonio
AU - Pi Barrio, J. Javier
AU - Piedrola Morato, Gonzalo
AU - Pou Torelló, José Ma
AU - Puigdevall Gallego, Victor
AU - Rodríguez Guerrero, Paloma
AU - Rodríguez Roble, Azuzena
AU - Romero Bobillo, Enrique
AU - Ruano Vieitez, Belén
PY - 2004/10/1
Y1 - 2004/10/1
N2 - Objective: To undertake a multicentre epidemiological study reflecting acromegaly in Spain. Design: Voluntary reporting of data on patients with acromegaly to an online database, by the managing physician. Methods: Data on demographics, diagnosis, estimated date of initial symptoms and diagnosis, pituitary imaging, visual fields, GH and IGF-I concentrations (requested locally), medical, radiotherapy and neurosurgical treatments, morbidity and mortality were collected. Results: Data were included for 1219 patients (60.8% women) with a mean age at diagnosis of 45 years (S.D. 14 years). Reporting was maximal in 1997 (2.1 cases per million inhabitants (c.p.m.) per year); prevalence was globally 36 c.p.m., but varied between 15.7 and 75.8 c.p.m. in different regions. Of 1196 pituitary tumours, most were macroadenomas (73%); 81% of these patients underwent surgery, 45% received radiotherapy and 65% were given medical treatment (somatostatin analogues in 68.3% and dopamine agonists in 31.4%). Cures (GH values (basal or after an oral glucose tolerance test) < 2 ng/ml, normal IGF-I, or both) were observed in 40.3% after surgery and 28.2% after radiotherapy. Hypertension (39.1%), diabetes mellitus (37.6%), hypopituitarism (25.7%), goitre (22.4%), carpal tunnel syndrome (18.7%) and sleep apnoea (13.2%) were reported as most frequent morbidities; 6.8% of the patients had cancer (breast in 3.1% of the women and colon in 1.2% of the cohort). Fifty-six patients died at a mean age of 60 years (S.D. 14 years), most commonly of a cardiovascular cause (39.4%); mortality was greater in patients given radiotherapy (hazard ratio 2.29; 95% confidence interval 1.03 to 5.08; P = 0.026), and in those in whom GH and IGF-I concentrations were never normal (P < 0.001). Conclusions: This acromegaly registry offers a realistic overview of the epidemiological characteristics, treatment outcome and morbidity of acromegaly in Spain. As active disease and treatment with radiotherapy are associated with an increase in mortality, efforts to control the disease early are desirable. © 2004 Society of the European Journal of Endocrinology.
AB - Objective: To undertake a multicentre epidemiological study reflecting acromegaly in Spain. Design: Voluntary reporting of data on patients with acromegaly to an online database, by the managing physician. Methods: Data on demographics, diagnosis, estimated date of initial symptoms and diagnosis, pituitary imaging, visual fields, GH and IGF-I concentrations (requested locally), medical, radiotherapy and neurosurgical treatments, morbidity and mortality were collected. Results: Data were included for 1219 patients (60.8% women) with a mean age at diagnosis of 45 years (S.D. 14 years). Reporting was maximal in 1997 (2.1 cases per million inhabitants (c.p.m.) per year); prevalence was globally 36 c.p.m., but varied between 15.7 and 75.8 c.p.m. in different regions. Of 1196 pituitary tumours, most were macroadenomas (73%); 81% of these patients underwent surgery, 45% received radiotherapy and 65% were given medical treatment (somatostatin analogues in 68.3% and dopamine agonists in 31.4%). Cures (GH values (basal or after an oral glucose tolerance test) < 2 ng/ml, normal IGF-I, or both) were observed in 40.3% after surgery and 28.2% after radiotherapy. Hypertension (39.1%), diabetes mellitus (37.6%), hypopituitarism (25.7%), goitre (22.4%), carpal tunnel syndrome (18.7%) and sleep apnoea (13.2%) were reported as most frequent morbidities; 6.8% of the patients had cancer (breast in 3.1% of the women and colon in 1.2% of the cohort). Fifty-six patients died at a mean age of 60 years (S.D. 14 years), most commonly of a cardiovascular cause (39.4%); mortality was greater in patients given radiotherapy (hazard ratio 2.29; 95% confidence interval 1.03 to 5.08; P = 0.026), and in those in whom GH and IGF-I concentrations were never normal (P < 0.001). Conclusions: This acromegaly registry offers a realistic overview of the epidemiological characteristics, treatment outcome and morbidity of acromegaly in Spain. As active disease and treatment with radiotherapy are associated with an increase in mortality, efforts to control the disease early are desirable. © 2004 Society of the European Journal of Endocrinology.
U2 - 10.1530/eje.0.1510439
DO - 10.1530/eje.0.1510439
M3 - Review article
VL - 151
SP - 439
EP - 446
IS - 4
ER -
