Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study
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Acromegaly incidence, prevalence, complications and long-term prognosis : a nationwide cohort study. / Dal, Jakob; Feldt-Rasmussen, Ulla; Andersen, Marianne; Kristensen, Lars Ø; Laurberg, Peter; Pedersen, Lars; Dekkers, Olaf M; Sørensen, Henrik Toft; Jørgensen, Jens Otto L.
In: European Journal of Endocrinology, Vol. 175, No. 3, 09.2016, p. 181-90.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Acromegaly incidence, prevalence, complications and long-term prognosis
T2 - a nationwide cohort study
AU - Dal, Jakob
AU - Feldt-Rasmussen, Ulla
AU - Andersen, Marianne
AU - Kristensen, Lars Ø
AU - Laurberg, Peter
AU - Pedersen, Lars
AU - Dekkers, Olaf M
AU - Sørensen, Henrik Toft
AU - Jørgensen, Jens Otto L.
N1 - © 2016 European Society of Endocrinology.
PY - 2016/9
Y1 - 2016/9
N2 - DESIGN: 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.METHOD: 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.RESULTS: 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.CONCLUSION: (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.
AB - DESIGN: 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.METHOD: 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.RESULTS: 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.CONCLUSION: (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.
KW - Acromegaly
KW - Adult
KW - Aged
KW - Cohort Studies
KW - Comorbidity
KW - Denmark
KW - Diabetes Mellitus
KW - Female
KW - Heart Failure
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Myocardial Infarction
KW - Prevalence
KW - Prognosis
KW - Registries
KW - Stroke
KW - Journal Article
U2 - 10.1530/EJE-16-0117
DO - 10.1530/EJE-16-0117
M3 - Journal article
C2 - 27280374
VL - 175
SP - 181
EP - 190
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
SN - 0804-4643
IS - 3
ER -
ID: 180069360