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Abstract：
Acromegaly is a rare disease with many comorbidities that impair quality of life and limit survival. There are discrepancies in various clinical guidelines regarding diagnosis and postoperative control criteria, as well as screening and optimal management of comorbidities. This expert consensus was aimed at establishing specific recommendations for the Spanish healthcare system. The existing recommendations, the scientific evidence on which they are based, and the main controversies are reviewed. Unfortunately, the low prevalence and high clinical variability of acromegaly do not provide strong scientific evidences. To mitigate this disadvantage, a modified Delphi questionnaire, combining the best available scientific evidence with the collective judgment of experts, was used. The questionnaire, generated after a face-to-face debate, was completed by 17 Spanish endocrinologists expert in acromegaly. A high degree of consensus was reached (79.3%), as 65 of the total 82 statements raised were accepted. Some criteria for diagnosis and postoperative control were identified by this procedure. Regarding comorbidities, recommendations have been established or suggested for screening and management of oncological, cardiovascular, respiratory (sleep apnea), metabolic (dyslipidemia and diabetes), musculoskeletal, and hypopituitarism-related disorders. Consensus recommendations may facilitate and homogenize clinical care to patients with acromegaly in the Spanish health system.
摘要：
肢端肥大症是一种罕见的疾病，有许多合并症，会损害生活质量并限制生存。关于诊断和术后控制标准的各种临床指南存在差异，以及合并症的筛查和优化管理。该专家共识旨在为西班牙医疗保健系统建立具体建议。现有建议，它们所依据的科学证据，并回顾了主要争议。不幸的是,肢端肥大症的低患病率和高临床变异性并不能提供强有力的科学依据.为了减轻这一缺点，修改后的德尔菲问卷，将现有的最佳科学证据与专家的集体判断相结合，被使用。问卷，经过面对面的辩论，由17名西班牙内分泌学家肢端肥大症专家完成。达成了高度共识(79.3%),因为所提出的82项陈述中有65项被接受.通过此程序确定了一些诊断和术后控制的标准。关于合并症，已建立或建议用于肿瘤筛查和管理，心血管,呼吸（睡眠呼吸暂停），代谢（血脂异常和糖尿病），肌肉骨骼，和垂体功能减退相关疾病。共识建议可能会促进和均匀化西班牙卫生系统中肢端肥大症患者的临床护理。
