Risk for Acromegaly-related Comorbidities by Sex in Korean Acromegaly

Abstract

Context Reports on the incidence, characteristics, and comorbidity in Asian patients with acromegaly are scarce. Objective To evaluate the incidence of acromegaly and the risk of comorbidities in East Asia, especially South Korea. Design This nationwide population-based cohort study using the Korean Health Insurance Review and Assessment claims database evaluated the incidence of acromegaly, initially diagnosed from 2010 to 2013. We identified comorbidities during, before, and 2 years after diagnosis. Acromegaly and control cases (718 and 7180, respectively) were included in the analysis. Setting A longitudinal case-control study using a nationwide population cohort. Results The mean annual incidence rate of acromegaly was 3.57 cases per 1 000 000. Malignancies occurred in 61 patients with acromegaly (8.5%) during the study period and thyroid cancer was the most common malignancy (n = 38). In the acromegaly group, the overall risk of malignancy was higher: hazard ratio (HR), 2.82 (95% confidence interval [CI]: 2.12–3.74). Malignancy risk was more pronounced in females, with increased risk from the prediagnosis period that is sustained until the postdiagnosis period. Prevalence of diabetes mellitus (DM) and heart failure increased significantly in acromegalic patients. Over the entire period, DM developed in 51.1% and 57.0% of male and female acromegalic patients, respectively. Mortality risk was higher (HR 1.65, 95%; CI: 1.13–2.41) and statistically significant in females (HR 1.75, 95%; CI: 1.07–2.84). Conclusion Comorbidities associated with acromegaly differed by sex in Korean subjects. High malignancy and mortality risk should be considered in female patients when managing acromegaly in Korea.

Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?

“…Colao et al [1] argued that the increasing prevalence in newer studies could be due to improvements in the diagnostic approach, or to the availability of larger databases. The former can be explained by higher rates of economic growth, improvement and access to healthcare [15]. The latter may be inaccurate, as the largest databases present in this review have lower prevalence rates than in Iceland or Malta and, yet have discrepancy amongst each other, potentially due to difference in data collection methods [8,19].…”

“…Furthermore, the highest incidence rate of 11 and 8 cpm/year were reported by Burton et al [8] and Hoskuldsdottir et al [12], respectively, while the majority of other studies present an incidence rate ranging from 3 to 4 cpm/year [10,11,13,15,16,18]. Improved awareness among internists and general practitioners, rise of social media and the introduction of a universal diagnostic method possibly lead to the increase in incidence rates in recent studies [1,46].…”

“…To this day, epidemiological data of acromegaly is highly variable, as shown by estimations of 20 studies in Table 1. Prevalence of acromegaly ranges from 18 to 133 cpm, whereas the incidence ranges from 1.9 to 11 cpm/year [7][8][9][10][11][12][13][14][15][16][17][18][19][39][40][41][42][43][44][45].…”

“…Albeit a rare disease, population-based studies have been able to determine the prevalence, ranging from 28 to 134 cases per million (cpm) and the incidence, ranging from 1.9 to 11 cpm per year [7][8][9][10][11][12][13][14][15][16][17][18][19]. Median age at diagnosis is within the fifth decade of life, but owing to the small population sizes it is hard to infer www.e-enm.org 207 differences in gender [20,21].…”

Epidemiology of Functioning Pituitary Adenomas

“…A limitation of survey methods is their high likelihood of representing patients treated at tertiary hospitals. In order to compensate for this limitation, Park et al[13] analyzed the Korean Health Insurance Review and Assessment (HIRA) claims database between 2010 and 2014 and reported an annual incidence rate of 3.57 per million.…”