Excess Mortality in AcromegalyHoldaway I.M.
Department of Endocrinology, Greenlane Clinical Centre, Auckland City Hospital, Auckland, New Zealand
Background: Increased production of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in patients with acromegaly is associated with a twofold increase in mortality compared with the general population. The range of standardised mortality rates in various studies ranges from 1.2 to 3.6. Predictors of Mortality: Multivariate analysis has indicated that post-treatment serum GH levels and, in a number of studies, serum IGF-I levels are the most powerful predictors of outcome. Normal IGF-I concentrations and random GH levels <2.5 µg/l measured by polyclonal radioimmunoassay result in optimal outcome. Other factors adversely influencing mortality include hypertension and a long interval between onset of the disorder and diagnosis. Conclusions: Analysis of recent reports suggests that adoption of treatment guidelines with appropriate post-treatment target ranges for GH and IGF-I, together with the availability of newer methods to control GH oversecretion, has significantly improved patient outcomes.
Ian Holdaway, MD
Greenlane Clinical Centre, Department of Endocrinology
PO Box 92189
Auckland 1142 (New Zealand)
Tel. +64 9 307 4949, Fax +64 9 307 4993, E-Mail email@example.com
Published online: December 10, 2007
Number of Print Pages : 7
Number of Figures : 8, Number of Tables : 2, Number of References : 29
Hormone Research (From Developmental Endocrinology to Clinical Research)
Vol. 68, No. Suppl. 5, Year 2007 (Cover Date: December 2007)
Journal Editor: Czernichow, P. (Paris)
ISSN: 0301–0163 (print), 1423–0046 (Online)
For additional information: http://www.karger.com/HRE