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肢端肥大症合并症的诊断与治疗共识:更新版。

A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update.

机构信息

Division of Endocrinology and Metabolism, San Raffaele University Hospital, Milan, Italy.

Division of Endocrinology, University of Michigan Health System, Ann Arbor, Michigan.

出版信息

J Clin Endocrinol Metab. 2020 Apr 1;105(4). doi: 10.1210/clinem/dgz096.

DOI:10.1210/clinem/dgz096
PMID:31606735
Abstract

OBJECTIVE

The aim of the Acromegaly Consensus Group was to revise and update the consensus on diagnosis and treatment of acromegaly comorbidities last published in 2013.

PARTICIPANTS

The Consensus Group, convened by 11 Steering Committee members, consisted of 45 experts in the medical and surgical management of acromegaly. The authors received no corporate funding or remuneration.

EVIDENCE

This evidence-based consensus was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence following critical discussion of the current literature on the diagnosis and treatment of acromegaly comorbidities.

CONSENSUS PROCESS

Acromegaly Consensus Group participants conducted comprehensive literature searches for English-language papers on selected topics, reviewed brief presentations on each topic, and discussed current practice and recommendations in breakout groups. Consensus recommendations were developed based on all presentations and discussions. Members of the Scientific Committee graded the quality of the supporting evidence and the consensus recommendations using the GRADE system.

CONCLUSIONS

Evidence-based approach consensus recommendations address important clinical issues regarding multidisciplinary management of acromegaly-related cardiovascular, endocrine, metabolic, and oncologic comorbidities, sleep apnea, and bone and joint disorders and their sequelae, as well as their effects on quality of life and mortality.

摘要

目的

肢端肥大症共识小组的目的是修订和更新 2013 年发布的关于肢端肥大症合并症诊断和治疗的共识。

参与者

共识小组由 11 名指导委员会成员召集,由 45 名肢端肥大症医疗和手术管理方面的专家组成。作者没有收到任何公司的资金或报酬。

证据

本循证共识是使用推荐分级的评估、制定与评价(GRADE)系统制定的,用于描述对肢端肥大症合并症的诊断和治疗的现有文献进行批判性讨论后,推荐的强度和证据的质量。

共识过程

肢端肥大症共识小组的参与者对选定主题的英文文献进行了全面的文献检索,审查了每个主题的简短介绍,并在分组讨论会上讨论了当前的实践和建议。根据所有的介绍和讨论,制定了共识建议。科学委员会成员使用 GRADE 系统对支持证据的质量和共识建议进行分级。

结论

循证方法共识建议涉及肢端肥大症相关心血管、内分泌、代谢和肿瘤合并症、睡眠呼吸暂停以及骨骼和关节疾病及其后遗症的多学科管理,以及它们对生活质量和死亡率的影响等重要临床问题。

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