Predictors of morbidity and mortality in acromegaly, an Italian survey.

Laura De Marinis Grasso, Antonio Bianchi, Maura Arosio, Giuseppe Reimondo, Elena Malchiodi, Paola Berchialla, Alberto Borraccino, Rosario Pivonello, Silvia Grottoli, Marco Losa, Salvatore Cannavò, Marcella Montini, Marta Bondanelli, Ernesto De Menis, Chiara Martini, Gabriella Angeletti, Antonino Velardo, Alessandro Peri, Marco Faustini Fustini, Patrizia TitaFrancesca Pigliaru, Giorgio Borretta, Carla Scaroni, Nicoletta Bazzoni, Marialuisa Appetecchia, Francesco Cavagnini, Gaetano Lombardo, Ezio Ghigo, Paolo Beck Peccoz, Annamaria Colao, Massimo Terzolo

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

135 Citazioni (Scopus)

Abstract

OBJECTIVE: To describe demographic and hormonal characteristics, co-morbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nation-wide survey of Italian acromegalic patients. DESIGN: Retrospective multicentre epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers . The mean follow-up time was 120 months. RESULTS: A total of 1512 patients, 41% M, mean age: 45±13 years, mean GH: 31±37 mcg/L, IGF-I: 744±318 ng/ml, were included. Diabetes mellitus was reported in 16% of cases, hypertension in 33%. Older age and higher IGF-I levels at diagnosis were significant predictors of diabetes and hypertension. At the last follow-up, 65% of patients had a controlled disease, of whom 55% were off medical therapy. Observed deaths were 61, with a standardized mortality ratio (SMR) of 1.13 (IC95%: 0.87-1.46). Mortality was significantly higher in the patients with persistently active disease (1.93; IC95%: 1.34-2.70). Main causes of death were vascular diseases and malignancies with similar prevalence. A multivariate analysis showed that older age, higher GH at last follow-up, higher IGF-I levels at diagnosis, malignancy and radiotherapy were independent predictors of mortality.Conclusions. Pre-treatment IGF-I levels are important predictors of morbidity and mortality in acromegaly. The full hormonal control of the disease, nowadays reached in the majority of patients with modern management, reduces greatly the disease-related mortality.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaEuropean Journal of Endocrinology
Stato di pubblicazionePubblicato - 2012

Keywords

  • acromegaly
  • epidemiology

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