Mortality in Acromegaly: A Metaanalysis

Dekkers, Olaf M.; Biermasz, Nienke R.; Pereira, Alberto M.; Romijn, Johannes A.; Vandenbroucke, Jan P.

doi:10.1210/jc.2007-1191

Cited by 476 publications

(346 citation statements)

References 29 publications

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“…If confirmed, this observation could somehow explain why life expectancy may remain slightly reduced in acromegalic patients successfully treated with surgery alone with respect to the general population (17). In fact, in our series of cured acromegalic patients, evaluated by the GHRH plus arginine test, GH peak was consistent with a severe GHD in about 60% of the subjects.…”

Section: Discussionsupporting

confidence: 68%

Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments

Ronchi¹,

Giavoli²,

Ferrante³

et al. 2009

European Journal of Endocrinology

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Objective: Radiotherapy (RT) for pituitary adenomas, including GH-secreting ones, frequently leads to GH deficiency (GHD). Data on the effects of surgery alone (S) on dynamic GH secretion are limited. The aim of the study was to investigate the occurrence of GHD in acromegalic patients treated with different therapeutic options. Design and methods: Fifty-six patients in remission from acromegaly, (33 F & 23 M, age: 54G13 years, body mass index (BMI): 28.4G4.1 kg/m 2 , 21 with adequately substituted pituitary deficiencies) treated by S alone (nZ33, group 1) or followed by RT (nZ23, group 2), were investigated for GHD by GHRH plus arginine testing, using BMI-adjusted cut-offs. Several metabolic and cardiovascular parameters (waist circumference, body fat percentage, blood pressure, fasting and post-oral glucose tolerance test glucose, HbA1c, insulin resistance and lipid profile) were evaluated in all the patients and 28 control subjects with known diagnosis of GHD. Results: Serum GH peak after challenge was 8.0G9.7 mg/l, without any correlation with post-glucose GH nadir and IGF-1 levels. The GH response indicated severe GHD in 34 patients (61%) and partial GHD in 15 patients (27%). IGF-1 were below the normal range in 14 patients (25%). The frequency of GHD was similar in the two treatment groups (54% in group 1 and 70% in group 2). No significant differences in metabolic parameters were observed between acromegalic patients and controls with GHD. Conclusions: Severe GHD may occur in about 60% of patients treated for acromegaly, even when cured after S alone. Thus, a stimulation test (i.e. GHRH plus arginine) is recommended in all cured acromegalic patients, independently from previous treatment.

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Section: Discussionsupporting

confidence: 68%

Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments

Ronchi¹,

Giavoli²,

Ferrante³

et al. 2009

European Journal of Endocrinology

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“…Cardiovascular disease is responsible for 60% of dea ths in patients with acromegaly (13,30). Alterations in glucose metabolism should be carefully evaluated and treated, as they may be implicated in the high mortality of these patients caused by cardiovascular disease (23,30,31).…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitusin a cohort of patients with acromegaly

Rodrigues

Costenaro

Fedrizzi

et al. 2011

Arq Bras Endocrinol Metab

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Objectives: To evaluate the presence of diabetes mellitus (DM) in a cohort of patients with acromegaly. Methods: This was a cross sectional study. Results: Fifty-eight acromegalic patients were assessed. Only 29% met the criteria for cure, and 27% had the disease controlled. Twenty-two had DM; HbA1c was equal to 7.34 ± 2.2%. Most of the diabetic patients (18 out of 22, 82%) did not meet criteria for cure. They were more often hypertensive [16/22 (73%)

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“…11,38,39 Caution is needed regarding the use of conventional radiation therapy owing to reports of increased mortality and morbidity, as well as development of local tissue damage (DR), but more data are needed on mortality and treatment-induced comorbidities with currently used focused techniques such as stereotactic radiation techniques.…”

Section: Clinical Outcomes With Drug Treatmentmentioning

confidence: 99%

Expert consensus document: A consensus on the medical treatment of acromegaly

et al. 2014

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| In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.

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Mortality in Acromegaly: A Metaanalysis

Abstract: This metaanalysis shows increased all-cause mortality in acromegalic patients, compared with the general population, even after transsphenoidal surgery.

Cited by 476 publications

References 29 publications

Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments

Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments

Diabetes mellitusin a cohort of patients with acromegaly

Expert consensus document: A consensus on the medical treatment of acromegaly

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