Changes in acromegaly comorbidities, treatment, and outcome over three decades: a nationwide cohort study

Christian Rosendal*, Mai Christiansen Arlien-Søborg, Eigil Husted Nielsen, Marianne Skovsager Andersen, Claus Larsen Feltoft, Marianne Klose, Mikkel Andreassen, Niels Henrik Bruun, Jens Otto Lunde Jørgensen, Jakob Dal

*Corresponding author for this work

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Abstract

OBJECTIVE: To study the time-dependent changes in disease features of Danish patients with acromegaly, including treatment modalities, biochemical outcome, and comorbidities, with a particular focus on cancer and mortality.

METHODS: Pertinent acromegaly-related variables were collected from 739 patients diagnosed since 1990. Data are presented across three decades (1990-1999, 2000-2009, and 2010-2021) based on the year of diagnosis or treatment initiation.

RESULTS: Adenoma size and insulin-like growth factor I (IGF-I) levels at diagnosis did not differ significantly between study periods. The risk of being diagnosed with diabetes, heart disease, sleep apnea, joint disease, and osteoporosis increased from the 1990s to the later decades, while the mortality risk declined to nearly half. The risk of cancer did not significantly change. Treatment changed toward the use of more medical therapy, and fewer patients underwent repeat surgeries or pituitary irradiation. A statistically significant increase in the proportion of patients achieving IGF-I normalization within 3-5 years was observed over time (69%, 83%, and 88%). The proportion of patients with three or more deficient pituitary hormones decreased significantly over time.

CONCLUSION: Modern medical treatment regimens of acromegaly as well as increased awareness and improved diagnostics for its comorbidities have led to better disease control, fewer patients with severe hypopituitarism, and declining mortality in the Danish cohort of acromegaly patients. The risk of cancer did not increase over the study period.

Original languageEnglish
Article number1380436
JournalFrontiers in Endocrinology
Volume15
Number of pages10
ISSN1664-2392
DOIs
Publication statusPublished - 4 Apr 2024

Bibliographical note

Copyright © 2024 Rosendal, Arlien-Søborg, Nielsen, Andersen, Feltoft, Klose, Andreassen, Bruun, Jørgensen and Dal.

Keywords

  • Acromegaly/epidemiology
  • Adenoma/diagnosis
  • Cohort Studies
  • Comorbidity
  • Humans
  • Insulin-Like Growth Factor I/metabolism
  • acromegaly comorbidities
  • acromegaly treatment
  • pituitary adenomas
  • acromegaly and cancer
  • acromegaly
  • cancer endocrinology

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