Epidemiology of acromegaly: review of population studies.

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Insulin 1 endocrinologydiseasesdrugs
acromegaly 28 endocrinologydiseases
diabetes mellitus 2 endocrinologydiseases
gigantism 1 endocrinologydiseases
type 2 diabetes mellitus 1 endocrinologydiseases

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Insulin 1401 system.IntroductionAcromegaly is a rare condition characterized by growth hormone (GH) excess and elevated Insulin -like growth factor 1 (IGF-I) levels attributed in the vast majority of cases, to a pituitary adenoma.
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acromegaly 32 Title: PituitaryEpidemiology of acromegaly : review of population studiesAikaterini LavrentakiAlessandro PaluzziJohn A. H. WassNiki KaravitakiPublication
acromegaly 1081 relating to diagnostic delays and posing challenges in the surgical management. Increased awareness of acromegaly amongst the medical community is of major importance aiming to reduce the adverse sequelae of late diagnosis
acromegaly 1637 uncontrolled disease and adequate biochemical control may restore it to normal [[1]].The presentation of acromegaly can be insidious and despite the advances in the field, there are significant diagnostic delays with
acromegaly 1892 patients. The recently published Endocrine Society clinical practice guidelines suggest screening for acromegaly by measurement of IGF-I in patients with typical clinical manifestations, but also in those who lack
acromegaly 2278 hyperhidrosis, and hypertension) [[2]]. The impact of this approach on the prevalence and incidence rates of acromegaly in the future remains to be elucidated.Accurate and up-to-date epidemiological data on acromegaly are
acromegaly 2376 of acromegaly in the future remains to be elucidated.Accurate and up-to-date epidemiological data on acromegaly are of major importance for describing patterns of disease and generating hypotheses on causal factors,
acromegaly 2627 condition and its co-morbidities on patients, families and the community, for evaluating the burden of acromegaly on the health care system and for providing guidance on optimal allocation of resources (clinical and
acromegaly 2890 improvement of patient outcomes.In this review, we will systematically analyse the epidemiological profile of acromegaly based on recently published population studies from various geographical areas. Data from cancer registries
acromegaly 3287 affected by selection bias and wide variations in the referral patterns across the world.Epidemiology of acromegaly The population studies assessing the epidemiology of acromegaly are shown in Table 1.Table 1Prevalence,
acromegaly 3350 patterns across the world.Epidemiology of acromegalyThe population studies assessing the epidemiology of acromegaly are shown in Table 1.Table 1Prevalence, incidence and age at diagnosis of acromegaly in population
acromegaly 3437 epidemiology of acromegaly are shown in Table 1.Table 1Prevalence, incidence and age at diagnosis of acromegaly in population studiesReferencePopulation coveredPrevalence (per 100,000)Annual incidence (per 100,000)Age
acromegaly 6422 and the Danish Register of Causes of Death. Bex et al. [[10]] collected information on patients with acromegaly through a nationwide survey involving all endocrinologists managing patients with pituitary disorders
acromegaly 6710 Liege and some local centers did not take part). Mestron et al. [[11]] analyzed data from the Spanish acromegaly registry in which patients were voluntarily registered by the managing physicians. Gruppetta et al.
acromegaly 7491 nationwide survey in South Korea selected 74 secondary and tertiary care hospitals where patients with acromegaly were diagnosed or treated by both endocrinologists and neurosurgeons.In the above studies, the sources
acromegaly 7988 and the extend of involvement of the private sector in the diagnosis and management of subjects with acromegaly need to be taken into account.Prevalence, incidence, sex distribution and age at diagnosisThe total
acromegaly 8513 Notably, the last two studies obtained information from the Swedish Pituitary Registry and the Spanish acromegaly registry, respectively, and the possibility of under-reporting cannot be excluded. It should be also
acromegaly 10213 [6], [8], [10], [12]].It is of note that relevant epidemiological data on gigantism or young-onset acromegaly are sparse and this is mainly attributed to the rarity of this entity; Daly et al. [[4]] and Kwon et
acromegaly 10376 rarity of this entity; Daly et al. [[4]] and Kwon et al. [[14]] reported that amongst the patients with acromegaly identified, 22.2 and 2.4 %, respectively were aged between 0 and 19 years. In such cases, and particularly
acromegaly 10541 between 0 and 19 years. In such cases, and particularly given the recent advances in the genetics of acromegaly , genetic causes need to be considered [[20]].Presentation and diagnostic delayThe frequency of the presenting
acromegaly 11583 when reviewing the frequency of the presenting signs and symptoms.Table 2Clinical manifestations of acromegaly at diagnosis as reported in population studiesReferencePresenting manifestations (%)Acral enlargementHeadachesCoarse
acromegaly 12623 and prone to recall bias. Nonetheless, these data highlight the need for enhancing the awareness of acromegaly amongst clinicians aiming to reduce the adverse sequelae of late detection and management.Table 3Duration
acromegaly 12772 the adverse sequelae of late detection and management.Table 3Duration of symptoms until diagnosis in acromegaly as reported in population studiesReferenceDuration of symptoms until diagnosis (years)Median (range)Total
acromegaly 13604 (Table 4) [[3]–[6], [8]–[12], [14]].Table 4Frequency of macro- and microadenomas in patients with acromegaly as reported in population studiesReferenceAdenoma sizeMacroadenoma (% of cases)Microadenoma (% of cases)MalesFemalesMalesFemalesFernandez
acromegaly 14168 add up to 100 due to cases with unknown tumor sizeEpidemiological data on the prevalence of familial acromegaly are limited. Bex et al. [[10]] identified four patients with MEN1 and two with Familial Isolated Pituitary
acromegaly 14558 total of 1219 subjects included in the Spanish Acromegaly Registry (0.25 %).ConclusionsThe rarity of acromegaly necessitates large population studies for the generation of reliable epidemiological data. In the last
acromegaly 15030 people/year, respectively. Whether these rates may change with the application of screening of patients with acromegaly -associated conditions remains to be clarified. The diagnostic delay is still considerable and the disease
acromegaly 15506 condition in the medical community.Further areas that remain to be clarified in the epidemiology of acromegaly include possible geographical variations and the impact of other factors (e.g. environmental, ethnic,
acromegaly 15747 system, availability and access to health care resources), as well as data on early-onset and familial acromegaly and on mixed GH-prolactin secreting adenomas. The latter will require adequate powered population collaborative
diabetes mellitus 2102 lack the typical clinical picture and have several associated conditions (sleep apnea syndrome, type 2 diabetes mellitus , debilitating arthritis, carpal tunnel syndrome, hyperhidrosis, and hypertension) [[2]]. The impact
diabetes mellitus 11151 [[7]] also looked at the presence of comorbidities at diagnosis and reported hypertension in 48 %, diabetes mellitus in 13 %, impaired glucose tolerance in 19 %, heart failure in 10 % and coronary artery disease in
gigantism 10188 females 38–56) [[3], [4], [6], [8], [10], [12]].It is of note that relevant epidemiological data on gigantism or young-onset acromegaly are sparse and this is mainly attributed to the rarity of this entity; Daly
type 2 diabetes mellitus 2095 who lack the typical clinical picture and have several associated conditions (sleep apnea syndrome, type 2 diabetes mellitus , debilitating arthritis, carpal tunnel syndrome, hyperhidrosis, and hypertension) [[2]]. The impact

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