Abstract
Data on sex differences in acromegaly at the time of diagnosis vary considerably between studies. 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. 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. 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 3.1years (CI95% 1.9-4.4), and the diagnostic delay was longer in females by 0.9years (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. 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.
Highlights
Is a rare disorder caused by chronic hypersecretion of growth hormone (GH)from a pituitary adenoma
The mean annual incidence rate (IR) of acromegaly was 3.3 cases/106 person-years (CI95% 2.9-3.7), which increased during the observation period
An increase in incidence appeared during the initial period, after which the incidence rate reached a plateau (1977-1988, IR: 2.2 cases /106 py (CI95%1.5-2.9) vs. 1989-2010, IR: 3.8 cases /106 py (CI95% 3.5-4.1), P
Summary
Is a rare disorder caused by chronic hypersecretion of growth hormone (GH)from a pituitary adenoma. As opposed to other hormone secreting pituitary tumours where a female preponderance is present, it is less clear if the incidence and prevalence of acromegaly differ between men and women [10]. Two recent reviews conclude that acromegaly is more prevalent in women but the gender distribution differs considerably between cohorts [11, 12]. Most of the observations on sex differences derive from registries reporting a low disease prevalence, which could indicate underdiagnosis of a subgroup of patients including older males with mild acromegaly [13, 14, 15, 16, 17]. A more even gender distribution has been reported in recent population-based surveys with overall higher disease prevalence [1, 3, 19, 20]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
