Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, Linkuo Chang Gung Memorial Hospital, Taoyuan, Taiwan.
J Formos Med Assoc. 2019 Oct;118(10):1430-1437. doi: 10.1016/j.jfma.2018.12.017. Epub 2019 Jan 4.
BACKGROUND/PURPOSE: The objectives of this study were to describe epidemiological data, treatment outcomes, and quality of life (QOL) of patients with acromegaly in Taiwan.
From 2013 to 2015, subjects with acromegaly were recruited through five medical centers. After enrollment, each patient was kept on observation for 1 year.
The analyzed cohort included 272 acromegalic subjects (117 males, 155 females) with a mean age of 51.4 ± 12.9 years. Their mean age at diagnosis was 41.8 ± 12.1 years. About 83.8% patients presented symptoms of facial changes. Galactorrhea was noted at the earliest age of 32.7 ± 9.1 years. The duration between the onset of symptoms/signs and diagnosis was 6.9 ± 8.1 years. Around 70.3% patients harbored a macroadenoma. At enrollment, percentages of patients ever received surgical intervention, radiotherapy, somatostatin analogs, and dopamine agonists were 94.8%, 27.9%, 64%, and 30%, respectively. At the final following-up visit, the random growth hormone (GH), nadir GH after oral glucose tolerance test, and the insulin-like growth factor 1 levels were 2.7 ± 4.9 μg/L, 2.4 ± 6.1 μg/L, and 291.5 ± 162.4 ng/mL, respectively. The remission rate assessed by random GH level (≦2 μg/L) was 63.8%. The mean AcroQoL scores for the total 22 items were 64.0 ± 19.7. About 42.8% patients never sensed or felt discomfort about their changes in appearance.
This study described the profiles of acromegaly in Taiwan. It is important to enhance early diagnosis and timely commencement of treatment to prevent serious complications of acromegaly.
背景/目的：本研究的目的是描述台湾地区肢端肥大症患者的流行病学数据、治疗结果和生活质量（QOL）。
2013 年至 2015 年，通过五家医疗中心招募肢端肥大症患者。入组后，每位患者接受为期 1 年的观察。
本分析队列纳入 272 例肢端肥大症患者（男 117 例，女 155 例），平均年龄 51.4±12.9 岁。诊断时的平均年龄为 41.8±12.1 岁。约 83.8%的患者有面部改变的症状。最早出现的症状是高泌乳素血症，年龄为 32.7±9.1 岁。症状/体征出现到确诊的时间间隔为 6.9±8.1 年。约 70.3%的患者有大腺瘤。入组时，曾接受手术干预、放疗、生长抑素类似物和多巴胺激动剂治疗的患者比例分别为 94.8%、27.9%、64%和 30%。在最后一次随访时，随机生长激素（GH）、口服葡萄糖耐量试验后 GH 最小值和胰岛素样生长因子 1 水平分别为 2.7±4.9μg/L、2.4±6.1μg/L 和 291.5±162.4ng/mL。根据随机 GH 水平（≦2μg/L）评估的缓解率为 63.8%。22 项总条目 AcroQoL 评分的平均值为 64.0±19.7。约 42.8%的患者从未感觉到或对自己外貌的变化感到不适。
本研究描述了台湾肢端肥大症的特征。重要的是要加强早期诊断和及时开始治疗，以预防肢端肥大症的严重并发症。
