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Title: Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Español de Acromegalia, REA)
Authors: Mestrón, Antonio
Webb, Susan M.
Astorga, Ricardo
Benito, Pedro
Catalá, Miguel
Gaztambide, Sonia
Gómez, José Manuel
Halperín, Irene
Lucas-Morante, Tomás
Moreno, Basilio
Obiols, Gabriel
de Pablos, Pedro
Páramo, Concha
Picó, Antonio
Torres, Elena
Varela, César
Vázquez, José Antonio
Zamora, Juana
Albareda, Mercè
Gilabert, Montserrat
Sánchez-Covisa, Miguel Aguirre
Alcaraz Tafalla, Marisol
Alonso Troncoso, Isabel
Álvarez Escolà, Cristina
Andía Melero, Victor Manuel
Arranz Martín, Alfonso
Arribas Palomar, Luis
Ballesteros Pomar, María
Beitia Martín, Juan José
López, Pedro Benito
Bernabeu Morón, Ignacio
Blanco Carrera, Concepción
Blanco Samper, Benito
Boronat Cortés, Mauro 
Carrera Santaliestra, Maria José
Castillo López, Luis
Cordero Diez, Ma del Mar
Costilla Martín, Enrique
Cózar León, Ma Victoria
Cuatrecasas Cambra, Guillem
De Luís Román, Daniel Antonio
de Miguel Novoa, Ma Paz
De Pablos Velasco, Pedro Luis 
Del Pozo Picó, Carlos
Diez Gómez, Juan José
Díez Hernández, Alberto
Duran Rodríguez-Hervada, Alejandra
de Antonio, Isabel Esteva
Fajardo Montañana, Carmen
Forga Llenas, Lluís
Fraile Saez, Ángel Luis
Galvez Moreno, Ma Angeles
García Centera, José Andrés
Gargallo Fernández, Manuel
Gavilán Villarejo, Inmaculada
Gil del Álamo, Paloma
Gilsanz Peral, Alberto
Gippini Pérez, Antonio
Gómez Balaguer, Marcelino
Gómez, Luis Alberto
Gorgojo Martínez, Juan José
Guerrero Martínez, Eduardo
Hernández Bayo, Juan Angel
Hernández López, Antonio
Iglesias, Pedro
Illán Gómez, Fátima
Jaunsolo Barranechea, Miguel Ángel
Lecube Torelló, Albert
Liante Peñambía, Gaspar
López dela Torre Casares, Martin
López Hernández, Elena
López López, José
López-Guzmán, Antonio
Lucas Martín, Ana
Marazuela Azpiroz, Mónica
Marco Martínez, Amparo
Marco Mur, Ángel Luis
Martin Castillo, Fidel
Martín González, Tomás
Martínez Brocca, Maria Asunció
Megia Colet, Ana
Merino Torres, Juan Francisco
Morales Gorría, Ma José
Morales Perez, Francisco
Murillo Sanchis, Jesús
Muros de Fuentes, Ma Teresa
Páramo Fernández, Concepción
Pavón de Paz, Isabel
Pazos Toral, Fernando
Pérez Corral, Ma Begoña
Pérez Pérez, Antonio
Pi Barrio, J. Javier
Piedrola Morato, Gonzalo
Pou Torelló, José Ma
Puigdevall Gallego, Victor
Rodríguez Guerrero, Paloma
Rodríguez Roble, Azuzena
Romero Bobillo, Enrique
Ruano Vieitez, Belén
UNESCO Clasification: 32 Ciencias médicas
Issue Date: 2004
Publisher: 0804-4643
Journal: European Journal of Endocrinology 
Abstract: Objective: To undertake a multicentre epidemiological study reflecting acromegaly in Spain. Design: Voluntary reporting of data on patients with acromegaly to an online database, by the managing physician. Methods: Data on demographics, diagnosis, estimated date of initial symptoms and diagnosis, pituitary imaging, visual fields, GH and IGF-I concentrations (requested locally), medical, radiotherapy and neurosurgical treatments, morbidity and mortality were collected. Results: Data were included for 1219 patients (60.8% women) with a mean age at diagnosis of 45 years (S.D. 14 years). Reporting was maximal in 1997 (2.1 cases per million inhabitants (c.p.m.) per year); prevalence was globally 36 c.p.m., but varied between 15.7 and 75.8 c.p.m. in different regions. Of 1196 pituitary tumours, most were macroadenomas (73%); 81% of these patients underwent surgery, 45% received radiotherapy and 65% were given medical treatment (somatostatin analogues in 68.3% and dopamine agonists in 31.4%). Cures (GH values (basal or after an oral glucose tolerance test) ,2 ng/ml, normal IGF-I, or both) were observed in 40.3% after surgery and 28.2% after radiotherapy. Hypertension (39.1%), diabetes mellitus (37.6%), hypopituitarism (25.7%), goitre (22.4%), carpal tunnel syndrome (18.7%) and sleep apnoea (13.2%) were reported as most frequent morbidities; 6.8% of the patients had cancer (breast in 3.1% of the women and colon in 1.2% of the cohort). Fifty-six patients died at a mean age of 60 years (S.D. 14 years), most commonly of a cardiovascular cause (39.4%); mortality was greater in patients given radiotherapy (hazard ratio 2.29; 95% confidence interval 1.03 to 5.08; P ¼ 0.026), and in those in whom GH and IGF-I concentrations were never normal (P , 0.001). Conclusions: This acromegaly registry offers a realistic overview of the epidemiological characteristics, treatment outcome and morbidity of acromegaly in Spain. As active disease and treatment with radiotherapy are associated with an increase in mortality, efforts to control the disease early are desirable.
ISSN: 0804-4643
DOI: 10.1530/eje.0.1510439
Source: European Journal of Endocrinology [ISSN 0804-4643], v. 151, p. 439-446
Appears in Collections:Reseña
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