Dupuy O, Petrossians P, Brue T, Morange I, Bordier L, Mayaudon H, Bauduceau B
Service d'endocrinologie et maladies métaboliques, HIA Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
Ann Endocrinol (Paris). 2009 Sep;70(4):225-9. doi: 10.1016/j.ando.2009.05.002. Epub 2009 Jun 18.
Multicentric registers such as The French Acromegaly Register provide data on rare disorders that are otherwise difficult to obtain, so avoiding extrapolation from limited data sets. This study focuses on clinical, hormonal and therapy characteristics of acromegaly in people over 70 years old. The objective was to compare this population with the youngest to disclose if the medical management was similar.
The data were obtained from the 30 centres that have registered patients in the Acromegaly Register since 1999.
The register listed 644 acromegaly patients on 1st January 2005, of whom 68 (22 men and 46 women) were over 70 years old, independently of the diagnosis date of their disease. Their average age was 76.8 + or - 5 years (range: 70-95) and they had suffered from acromegaly for 11 + or - 6 years (compared to 7 years in those aged less than 70). Their BMI were similar. Diabetes and hypertension were more frequent than in younger acromegalic patients and in the general French population matched for age. Circulating GH and IGF-1 concentrations were lower than in the younger acromegalic patients on inclusion and 1 year after treatment. There was no significant difference in the tumor size. Only 44% of the patients over 70 underwent surgery, against 90% of patients under 70 years. However, the fractions of young and elderly patients with a controlled disease 1 year after inclusion were the same (51%).
In the limits of the use of register, these data reveal a high prevalence of diabetes and hypertension in the eldest acromegalic patients. Despite much less frequent surgical intervention, patients' disease under control is equivalent to the younger population 1 year after the initial interview, confirming the effectiveness of the choices of treatment.
多中心登记处,如法国肢端肥大症登记处,提供了关于罕见疾病的数据,否则这些数据很难获得,从而避免了从有限数据集中进行推断。本研究聚焦于70岁以上肢端肥大症患者的临床、激素和治疗特征。目的是将该人群与最年轻的人群进行比较,以揭示医疗管理是否相似。
数据来自自1999年起在肢端肥大症登记处登记患者的30个中心。
登记处列出了2005年1月1日的644例肢端肥大症患者,其中68例(22名男性和46名女性)年龄超过70岁,与他们疾病的诊断日期无关。他们的平均年龄为76.8±5岁(范围:70 - 95岁),患肢端肥大症11±6年(相比之下,70岁以下患者为7年)。他们的体重指数相似。糖尿病和高血压在老年肢端肥大症患者中比在年轻肢端肥大症患者以及年龄匹配的法国普通人群中更常见。纳入时和治疗1年后,循环生长激素和胰岛素样生长因子 - 1浓度低于年轻肢端肥大症患者。肿瘤大小无显著差异。70岁以上患者中只有44%接受了手术,而70岁以下患者为90%。然而,纳入1年后疾病得到控制的年轻和老年患者比例相同(51%)。
在登记处使用的局限性内,这些数据显示老年肢端肥大症患者中糖尿病和高血压的患病率很高。尽管手术干预频率低得多,但初次访谈1年后患者疾病得到控制的情况与年轻人群相当,证实了治疗选择的有效性。