Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Español de Acromegalia, REA)

Antonio Mestrón, Susan M. Webb, Ricardo Astorga, Pedro Benito, Miguel Catalá, Sonia Gaztambide, José Manuel Gómez, Irene Halperín, Tomás Lucas-Morante, Basilio Moreno, Gabriel Obiols, Pedro de Pablos, Concha Páramo, Antonio Picó, Elena Torres, César Varela, José Antonio Vázquez, Juana Zamora, Mercè Albareda, Montserrat GilabertMiguel Aguirre Sánchez-Covisa, Marisol Alcaraz Tafalla, Isabel Alonso Troncoso, Cristina Álvarez Escolà, Victor Manuel Andía Melero, Alfonso Arranz Martín, Luis Arribas Palomar, María Ballesteros Pomar, Juan José Beitia Martín, Pedro Benito López, Ignacio Bernabeu Morón, Concepción Blanco Carrera, Benito Blanco Samper, Mauro Boronat Cortés, Maria José Carrera Santaliestra, Luis Castillo López, Ma del Mar Cordero Diez, Enrique Costilla Martín, Ma Victoria Cózar León, Guillem Cuatrecasas Cambra, Daniel Antonio De Luís Román, Ma Paz de Miguel Novoa, Pedro De Pablos Velasco, Carlos Del Pozo Picó, Juan José Diez Gómez, Alberto Díez Hernández, Alejandra Duran Rodríguez-Hervada, Isabel Esteva de Antonio, Carmen Fajardo Montañana, Lluís Forga Llenas, Ángel Luis Fraile Saez, Ma Angeles Galvez Moreno, José Andrés García Centera, Manuel Gargallo Fernández, Inmaculada Gavilán Villarejo, Paloma Gil del Álamo, Alberto Gilsanz Peral, Antonio Gippini Pérez, Marcelino Gómez Balaguer, Luis Alberto Gómez, Juan José Gorgojo Martínez, Eduardo Guerrero Martínez, Juan Angel Hernández Bayo, Antonio Hernández López, Pedro Iglesias, Fátima Illán Gómez, Miguel Ángel Jaunsolo Barranechea, Albert Lecube Torelló, Gaspar Liante Peñambía, Martin López dela Torre Casares, Elena López Hernández, José López López, Antonio López-Guzmán, Ana Lucas Martín, Mónica Marazuela Azpiroz, Amparo Marco Martínez, Ángel Luis Marco Mur, Fidel Martin Castillo, Tomás Martín González, Maria Asunció Martínez Brocca, Ana Megia Colet, Juan Francisco Merino Torres, Ma José Morales Gorría, Francisco Morales Perez, Jesús Murillo Sanchis, Ma Teresa Muros de Fuentes, Concepción Páramo Fernández, Isabel Pavón de Paz, Fernando Pazos Toral, Ma Begoña Pérez Corral, Antonio Pérez Pérez, J. Javier Pi Barrio, Gonzalo Piedrola Morato, José Ma Pou Torelló, Victor Puigdevall Gallego, Paloma Rodríguez Guerrero, Azuzena Rodríguez Roble, Enrique Romero Bobillo, Belén Ruano Vieitez

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287 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)439-446
JournalEuropean Journal of Endocrinology
Volume151
Issue number4
DOIs
Publication statusPublished - 1 Oct 2004

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