Sex differences in acromegaly at diagnosis: A nationwide cohort study and meta-analysis of the literature

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  • Jakob Dal, Aalborg Universitet, Steno Diabetes Center
  • ,
  • Benedikte G. Skov
  • ,
  • Marianne Andersen, Syddansk Universitet
  • ,
  • Ulla Feldt-Rasmussen, Københavns Universitet
  • ,
  • Claus L. Feltoft, Københavns Universitet
  • ,
  • Jesper Karmisholt, Aalborg Universitet
  • ,
  • Eigil H. Nielsen, Aalborg Universitet
  • ,
  • Olaf M. Dekkers
  • Jens Otto L. Jørgensen

Objective: Data on sex differences in acromegaly at the time of diagnosis vary considerably between studies. Design: A nationwide cohort study including all incident cases of acromegaly (1978–2010, n = 596) and a meta-analysis on sex differences in active acromegaly (40 studies) were performed. Method: Sex-dependent differences in prevalence, age at diagnosis, diagnostic delay, pituitary adenoma size, insulin-like growth factor 1 (IGF-I) and growth hormone (GH) concentrations were estimated. Results: The cohort study identified a balanced gender distribution (49.6% females) and a comparable age (years) at diagnosis (48.2 CI95% 46.5–49.8 (males) vs. 47.2 CI95% 45.5–48.9 (females), p = 0.4). The incidence rate significantly increased during the study period (R2 = 0.42, p < 0.01) and the gender ratio (F/M) changed from female predominance to an even ratio (SR: 1.4 vs. 0.9, p = 0.03). IGF-ISDS was significantly lower in females compared to males, whereas neither nadir GH nor pituitary adenoma size differed between males and females. In the meta-analysis, the weighted percentage female was 53.3% (CI95% 51.5–55.2) with considerable heterogeneity (I2 = 85%) among the studies. The mean age difference at diagnosis between genders was 3.1 years (CI95% 1.9–4.4), and the diagnostic delay was longer in females by 0.9 years (CI95% −0.4 to 2.1). Serum IGF-I levels were significantly lower in female patients, whereas nadir GH, and pituitary adenoma size were comparable. Conclusion: There are only a minor sex differences in the epidemiology of acromegaly at the time of diagnosis except that female patients are slightly older and exhibit lower IGF-I concentrations and a longer diagnostic delay.

TidsskriftClinical Endocrinology
Sider (fra-til)625-635
Antal sider11
StatusUdgivet - apr. 2021

Bibliografisk note

Funding Information:
JD: unrestricted research grants and lecture fee from Pfizer, JOJ: Grants and lecture fees from Pfizer, IPSEN and Novartis, CF: Lecture fee from Bristol Myers Squibb.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd

Copyright 2021 Elsevier B.V., All rights reserved.

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