Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Eur J Endocrinol. 2021 Jul 1;185(2):251-263. doi: 10.1530/EJE-21-0216.
To date, no systematic reviews and meta-analysis on the global epidemiology of acromegaly are available in the literature. The aims of this study are to provide a systematic review and a meta-analysis of the global epidemiology of acromegaly and to evaluate the quality of study reporting for the identified studies.
MEDLINE, EMBASE and The Cochrane Library databases were searched for studies assessing the epidemiology of acromegaly from inception until 31 January 2020. We included original observational studies written in English, reporting acromegaly prevalence and/or incidence for a well-defined geographic area. Two reviewers independently extracted data and performed quality assessments. Prevalence and incidence pooled estimates were derived by performing a random-effects meta-analysis.
A total of 32 studies were included in the systematic review, and 22 of them were included in the meta-analysis. The pooled prevalence of acromegaly was 5.9 (95% CI: 4.4-7.9) per 100 000 persons, while the incidence rate (IR) was 0.38 (95% CI: 0.32-0.44) cases per 100 000 person-years. For both prevalence and IR, considerable between-study heterogeneity was found (I2 = 99.3 and 86.0%, respectively). The quality of study reporting was rated as the medium for 20 studies and low for 12 studies.
Although the largest amount of heterogeneity was due to the high precision of the studies' estimates, data source and geographic area could represent relevant study-level factors which could explain about 50% of the total between-study variability. Large-scale high-quality studies on the epidemiology of acromegaly are warranted to help the public health system in making decisions.
目前，文献中尚无关于肢端肥大症全球流行病学的系统评价和荟萃分析。本研究旨在对肢端肥大症的全球流行病学进行系统评价和荟萃分析，并评估所确定研究报告的质量。
检索 MEDLINE、EMBASE 和 Cochrane Library 数据库，以评估截至 2020 年 1 月 31 日肢端肥大症的流行病学研究。我们纳入了评估明确地理区域肢端肥大症患病率和/或发病率的原始观察性研究，报告采用英文撰写。两位审查员独立提取数据并进行质量评估。采用随机效应荟萃分析得出患病率和发病率的汇总估计值。
系统评价共纳入 32 项研究，其中 22 项研究纳入荟萃分析。肢端肥大症的患病率汇总为 5.9（95%CI：4.4-7.9）/100000 人，而发病率（IR）为 0.38（95%CI：0.32-0.44）/100000 人年。患病率和发病率的研究间异质性均较大（分别为 I2 = 99.3%和 86.0%）。20 项研究的报告质量评分为中等，12 项研究的报告质量评分为低。
尽管大部分异质性归因于研究估计值的高度精确性，但数据来源和地理区域可能代表了相关的研究水平因素，可解释总研究间变异性的约 50%。需要开展大规模高质量的肢端肥大症流行病学研究，以帮助公共卫生系统做出决策。
