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列日肢端肥大症调查(LAS):肢端肥大症研究的新软件工具。

The Liege Acromegaly Survey (LAS): a new software tool for the study of acromegaly.

机构信息

Department of Endocrinology, Centre Hospitalier de Liège, University of Liege, Domaine Universitaire du Sart-Tilman, 4000 Liege, Belgium.

出版信息

Ann Endocrinol (Paris). 2012 Jun;73(3):190-201. doi: 10.1016/j.ando.2012.05.001. Epub 2012 Jun 9.

Abstract

Acromegaly is a chronic rare disease associated with negative pathological effects on multiple systems and organs. We designed a new informatics tool to study data from patients with acromegaly, the Liege Acromegaly Survey (LAS). This relational database permits the inclusion of anonymous historical and prospective data on patients and includes pathophysiology, clinical features, responses to therapy and long term outcomes of acromegaly. We deployed the LAS in a validation study at a single center in order to study the characteristics of patients with acromegaly diagnosed at our center from 1970-2011. A total of 290 patients with acromegaly were included (147 males and 143 females). There was a linear relationship between age at diagnosis and the date of diagnosis, indicating that older patients are being diagnosed with acromegaly more frequently. A majority presented with macroadenomas (77.5%) and the median diameter was 14 mm. Patients with macroadenomas were significantly younger than patients with microadenomas (P=0.01). GH values at diagnosis decreased with the age of the patients (P=0.01) and there was a correlation between GH values and tumor size at diagnosis (P=0.02). No correlation existed between insulin-like growth factor 1 (IGF-1) levels and tumor characteristics. The prevalence of diabetes was 21.4% in this population and 41.0% had hypertension. The presence of hypertension and diabetes were significantly associated with one another (P<0.001). There was a linear relation between initial GH and IGF-1 levels at diagnosis and those obtained during SSA analog treatment and the lowest GH and IGF-1 values following SSA therapy were obtained in older patients (GH: P<0.001; IGF-1: P<0.001). The LAS is a new relational database that is feasible to use in the clinical research setting and permits ready pooling of anonymous patient data from multiple study sites to undertake robust statistical analyses of clinical and therapeutic characteristics.

摘要

肢端肥大症是一种与多个系统和器官的负面病理效应相关的慢性罕见疾病。我们设计了一种新的信息学工具来研究肢端肥大症患者的数据,即列日肢端肥大症调查(LAS)。这个关系数据库允许包含患者的匿名历史和前瞻性数据,包括病理生理学、临床特征、对治疗的反应和肢端肥大症的长期结果。我们在一个单一中心的验证研究中部署了 LAS,以研究我们中心在 1970 年至 2011 年期间诊断出的肢端肥大症患者的特征。共纳入 290 例肢端肥大症患者(男 147 例,女 143 例)。诊断时的年龄与诊断日期之间存在线性关系,表明年龄较大的患者被诊断为肢端肥大症的频率更高。大多数患者表现为大腺瘤(77.5%),且直径中位数为 14mm。大腺瘤患者明显比微腺瘤患者年轻(P=0.01)。诊断时的 GH 值随患者年龄的增加而降低(P=0.01),并且 GH 值与诊断时肿瘤大小之间存在相关性(P=0.02)。IGF-1 水平与肿瘤特征之间无相关性。该人群中糖尿病的患病率为 21.4%,高血压的患病率为 41.0%。高血压和糖尿病的存在显著相关(P<0.001)。诊断时的初始 GH 和 IGF-1 水平与 SSA 类似物治疗期间获得的水平之间存在线性关系,并且在 SSA 治疗后获得的 GH 和 IGF-1 最低值在年龄较大的患者中(GH:P<0.001;IGF-1:P<0.001)。LAS 是一种新的关系数据库,可在临床研究环境中使用,并允许从多个研究地点方便地汇集匿名患者数据,以对临床和治疗特征进行稳健的统计分析。

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