■为了研究丹麦肢端肥大症患者疾病特征的时间依赖性变化,包括治疗方式,生化结果,和合并症,特别关注癌症和死亡率。
■收集了自1990年以来诊断的739例患者的相关肢端肥大症相关变量。数据是基于诊断或治疗开始年份的三十年(1990-1999,2000-2009和2010-2021)。
■诊断时的腺瘤大小和胰岛素样生长因子I(IGF-I)水平在研究期间之间没有显着差异。被诊断为糖尿病的风险,心脏病,睡眠呼吸暂停,关节疾病,骨质疏松症从1990年代到后来的几十年增加,而死亡风险下降到近一半。癌症的风险没有明显变化。治疗转向使用更多的药物治疗,接受重复手术或垂体照射的患者较少。随着时间的推移,观察到在3-5年内实现IGF-I正常化的患者比例有统计学意义的增加(69%,83%,和88%)。随着时间的推移,具有三种或三种以上垂体激素缺乏的患者比例显着下降。
■肢端肥大症的现代医学治疗方案以及对其合并症的认识提高和诊断改进,使疾病得到了更好的控制。较少患有严重垂体功能减退症的患者,丹麦肢端肥大症患者队列死亡率下降。在研究期间,癌症的风险没有增加。
UNASSIGNED: To study the time-dependent changes in disease features of Danish patients with acromegaly, including treatment modalities, biochemical outcome, and comorbidities, with a particular focus on cancer and mortality.
UNASSIGNED: Pertinent acromegaly-related variables were collected from 739 patients diagnosed since 1990. Data are presented across three decades (1990-1999, 2000-2009, and 2010-2021) based on the year of diagnosis or treatment initiation.
UNASSIGNED: Adenoma size and insulin-like growth factor I (IGF-I) levels at diagnosis did not differ significantly between study periods. The risk of being diagnosed with diabetes, heart disease, sleep apnea, joint disease, and osteoporosis increased from the 1990s to the later decades, while the mortality risk declined to nearly half. The risk of cancer did not significantly change. Treatment changed toward the use of more medical therapy, and fewer patients underwent repeat surgeries or pituitary irradiation. A statistically significant increase in the proportion of patients achieving IGF-I normalization within 3-5 years was observed over time (69%, 83%, and 88%). The proportion of patients with three or more deficient pituitary hormones decreased significantly over time.
UNASSIGNED: Modern medical treatment regimens of acromegaly as well as increased awareness and improved diagnostics for its comorbidities have led to better disease control, fewer patients with severe hypopituitarism, and declining mortality in the Danish cohort of acromegaly patients. The risk of cancer did not increase over the study period.