Clinical features and complications of acromegaly at diagnosis are not all the same: data from two large referral centers

in Endocrine Connections
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  • 1 E Varlamov, Departments of Medicine (Endocrinology, Diabetes and Clinical Nutrition) and Neurological Surgery, and Pituitary Center, Oregon Health & Science University, Portland, United States
  • 2 D Niculescu, Pituitary and Neuroendocrine Disorders, C. I. Parhon National Institute of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
  • 3 S Banskota, Neurological Surgery and Pituitary Center, Oregon Health & Science University, Portland, United States
  • 4 S Galoiu, Pituitary and Neuroendocrine Disorders, C. I. Parhon National Institute of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
  • 5 C Poiana, Pituitary and Neuroendocrine Disorders, C. I. Parhon National Institute of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania
  • 6 M Fleseriu, Oregon Health & Science University, Portland, United States

Correspondence: Maria Fleseriu, Email: fleseriu@ohsu.edu

Purpose: The number of international acromegaly-related registries is increasing; however, heterogeneity of acromegaly symptoms and signs across countries is not well described. We compared clinical disease manifestations at diagnosis between two large University referral centers from two continents.

Methods: Retrospective, comparative epidemiological study of acromegaly patients at two centers; 1) C. I. Parhon National Institute of Endocrinology, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania (Parhon), and 2) Pituitary Center, Oregon Health & Science University, Portland, Oregon, United States (OHSU) from approved registries was undertaken. Data were extracted from medical charts and questionnaires. Binary logistic regression analysis was undertaken for the most frequently noted symptoms and clinical signs.

Results: Study included 216 patients (87 Parhon, 129 OHSU). Age, sex and median delay in diagnosis were similar between centers. IGF-1 index was higher in patients at Parhon (3.3 vs 2.1, p < 0.001). The top five symptoms at both centers were; enlarged hands/feet, headache, arthralgia, fatigue, and irregular menses in women. A significant difference was noted for multiple signs and symptoms frequency, often >20 percentage points between centers. Center was a predictor of many signs and symptoms, independent of acromegaly biochemical severity or disease duration.

Conclusion: We show in the first comparative study that differences in medical practice, documentation, and likely cultural differences can influence patients’ symptom(s) reporting and screening patterns in geographically different populations. Pooling data into large multicenter international registries databases may lead to loss of regional characteristics and thus a mixed overall picture of combined cohorts.

 

     European Society of Endocrinology

     Society for Endocrinology

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