Carmichael John D, Broder Michael S, Cherepanov Dasha, Chang Eunice, Mamelak Adam, Said Qayyim, Neary Maureen P, Bonert Vivien
Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
Partnership for Health Analytic Research, LLC, 280 S. Beverly Dr., Suite 404, Beverly Hills, CA, 90212, USA.
BMC Endocr Disord. 2017 Mar 9;17(1):15. doi: 10.1186/s12902-017-0166-6.
The study aim was to estimate the proportion of acromegaly patients with various comorbidities and to determine if biochemical control was associated with reduced proportion of cardiovascular risk factors.
Data were from a single-center acromegaly registry. Study patients were followed for ≥12 months after initial treatment. Study period was from first to last insulin-like growth factor-I and growth hormone tests.
Of 121 patients, 55% were female. Mean age at diagnosis was 42.4 (SD: 15.0). Mean study period was 8.8 (SD: 7.2) years. Macroadenomas were observed in 93 of 106 patients (87.7%), and microadenomas in 13 (12.3%). Initial treatment was surgery in 104 patients (86%), pharmacotherapy in 16 (13.2%), and radiation therapy in 1 (0.8%). Of 120 patients, 79 (65.8%) achieved control during the study period. New onset comorbidities (reported 6 months after study start) were uncommon (<10%). Comorbidities were typically more prevalent in uncontrolled versus controlled patients-24 (58.5%) vs. 33 (41.8%) had hypertension, 17 (41.5%) vs. 20 (25.3%) had diabetes, 11 (26.8%) vs. 16 (20.3%) had sleep apnea, and 3 (7.3%) vs. 3 (3.8%) had cardiomyopathy-except for colon polyps or cancer (19.5% vs. 20.3%), left ventricular hypertrophy (9.8% vs. 11.4%), and visual defects (14.6% vs. 17.7%).
A greater number of comorbidities were observed in biochemically uncontrolled patients with acromegaly compared to their controlled counterparts in this single-center registry. About a third of the patients remained uncontrolled after a mean of >8 years of treatment, demonstrating the difficulty of achieving control in some patients.
本研究旨在评估肢端肥大症患者各种合并症的比例，并确定生化指标的控制是否与心血管危险因素比例的降低相关。
数据来自单中心肢端肥大症登记处。研究患者在初始治疗后随访≥12个月。研究期间为首次至末次胰岛素样生长因子-I和生长激素检测期间。
121例患者中，55%为女性。诊断时的平均年龄为42.4岁（标准差：15.0）。平均研究期为8.8年（标准差：7.2）。106例患者中有93例（87.7%）观察到垂体大腺瘤，13例（12.3%）为垂体微腺瘤。104例患者（86%）初始治疗为手术，16例（13.2%）为药物治疗，1例（0.8%）为放射治疗。120例患者中，79例（65.8%）在研究期间实现了控制。新出现的合并症（研究开始6个月后报告）并不常见（<10%）。合并症在未控制组患者中通常比控制组更普遍——高血压患者分别为24例（58.5%）和33例（41.8%），糖尿病患者分别为17例（41.5%）和20例（25.3%），睡眠呼吸暂停患者分别为11例（26.8%）和16例（20.3%），心肌病患者分别为3例（7.3%）和3例（3.8%）——结肠息肉或癌症（19.5%对20.3%）、左心室肥厚（9.8%对11.4%）和视力缺陷（14.6%对17.7%）除外。
在这个单中心登记处中，与生化指标得到控制的肢端肥大症患者相比，未得到控制的患者观察到更多的合并症。平均经过8年多的治疗后，约三分之一的患者仍未得到控制，这表明在一些患者中实现控制存在困难。
