Sex differences in acromegaly at diagnosis: A nationwide cohort study and meta-analysis of the literature
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Objective: Data on sex differences in acromegaly at the time of diagnosis vary considerably between studies. Design: A nationwide cohort study including all incident cases of acromegaly (1978–2010, n = 596) and a meta-analysis on sex differences in active acromegaly (40 studies) were performed. Method: Sex-dependent differences in prevalence, age at diagnosis, diagnostic delay, pituitary adenoma size, insulin-like growth factor 1 (IGF-I) and growth hormone (GH) concentrations were estimated. Results: The cohort study identified a balanced gender distribution (49.6% females) and a comparable age (years) at diagnosis (48.2 CI95% 46.5–49.8 (males) vs. 47.2 CI95% 45.5–48.9 (females), p = 0.4). The incidence rate significantly increased during the study period (R2 = 0.42, p < 0.01) and the gender ratio (F/M) changed from female predominance to an even ratio (SR: 1.4 vs. 0.9, p = 0.03). IGF-ISDS was significantly lower in females compared to males, whereas neither nadir GH nor pituitary adenoma size differed between males and females. In the meta-analysis, the weighted percentage female was 53.3% (CI95% 51.5–55.2) with considerable heterogeneity (I2 = 85%) among the studies. The mean age difference at diagnosis between genders was 3.1 years (CI95% 1.9–4.4), and the diagnostic delay was longer in females by 0.9 years (CI95% −0.4 to 2.1). Serum IGF-I levels were significantly lower in female patients, whereas nadir GH, and pituitary adenoma size were comparable. Conclusion: There are only a minor sex differences in the epidemiology of acromegaly at the time of diagnosis except that female patients are slightly older and exhibit lower IGF-I concentrations and a longer diagnostic delay.
Original language | English |
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Journal | Clinical Endocrinology |
Volume | 94 |
Issue number | 4 |
Pages (from-to) | 625-635 |
Number of pages | 11 |
ISSN | 0300-0664 |
DOIs | |
Publication status | Published - 2021 |
Bibliographical note
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
- acromegaly, age, diagnostic delay, gender, GH, IGF-I, sex
Research areas
ID: 263003615