OBJECTIVE: To describe demographic and hormonal characteristics, co-morbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nation-wide survey of Italian acromegalic patients. DESIGN: Retrospective multicentre epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers . The mean follow-up time was 120 months. RESULTS: A total of 1512 patients, 41% M, mean age: 45±13 years, mean GH: 31±37 mcg/L, IGF-I: 744±318 ng/ml, were included. Diabetes mellitus was reported in 16% of cases, hypertension in 33%. Older age and higher IGF-I levels at diagnosis were significant predictors of diabetes and hypertension. At the last follow-up, 65% of patients had a controlled disease, of whom 55% were off medical therapy. Observed deaths were 61, with a standardized mortality ratio (SMR) of 1.13 (IC95%: 0.87-1.46). Mortality was significantly higher in the patients with persistently active disease (1.93; IC95%: 1.34-2.70). Main causes of death were vascular diseases and malignancies with similar prevalence. A multivariate analysis showed that older age, higher GH at last follow-up, higher IGF-I levels at diagnosis, malignancy and radiotherapy were independent predictors of mortality.Conclusions. Pre-treatment IGF-I levels are important predictors of morbidity and mortality in acromegaly. The full hormonal control of the disease, nowadays reached in the majority of patients with modern management, reduces greatly the disease-related mortality.

Predictors of morbidity and mortality in acromegaly: an Italian survey.

Reimondo G;Berchialla P;Borraccino A;Grottoli S;Ghigo E;Terzolo M.
2012

Abstract

OBJECTIVE: To describe demographic and hormonal characteristics, co-morbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nation-wide survey of Italian acromegalic patients. DESIGN: Retrospective multicentre epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers . The mean follow-up time was 120 months. RESULTS: A total of 1512 patients, 41% M, mean age: 45±13 years, mean GH: 31±37 mcg/L, IGF-I: 744±318 ng/ml, were included. Diabetes mellitus was reported in 16% of cases, hypertension in 33%. Older age and higher IGF-I levels at diagnosis were significant predictors of diabetes and hypertension. At the last follow-up, 65% of patients had a controlled disease, of whom 55% were off medical therapy. Observed deaths were 61, with a standardized mortality ratio (SMR) of 1.13 (IC95%: 0.87-1.46). Mortality was significantly higher in the patients with persistently active disease (1.93; IC95%: 1.34-2.70). Main causes of death were vascular diseases and malignancies with similar prevalence. A multivariate analysis showed that older age, higher GH at last follow-up, higher IGF-I levels at diagnosis, malignancy and radiotherapy were independent predictors of mortality.Conclusions. Pre-treatment IGF-I levels are important predictors of morbidity and mortality in acromegaly. The full hormonal control of the disease, nowadays reached in the majority of patients with modern management, reduces greatly the disease-related mortality.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
167
2
189
198
acromegaly; mortality
Arosio M; Reimondo G; Malchiodi E; Berchialla P; Borraccino A; De Marinis L; Pivonello R; Grottoli S; Losa M; Cannavò S; Minuto F; Montini M; Bondanelli M; Demenis E; Martini C; Angeletti G; Velardo A; Peri A; Faustini-Fustini M; Tita P; Pigliaru F; Borretta G; Scaroni C; Bazzoni N; Bianchi A; Appetecchia M; Cavagnini F; Lombardi G; Ghigo E; Beck-Peccoz P; Colao A; Terzolo M.
File in questo prodotto:
File Dimensione Formato  
Predictor.pdf

accesso aperto

Tipo di file: POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione 670.98 kB
Formato Adobe PDF
670.98 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/102542
Citazioni
  • ???jsp.display-item.citation.pmc??? 46
  • Scopus 144
  • ???jsp.display-item.citation.isi??? 137
social impact