Malignancy, mortality risk higher among Korean women vs. men with acromegaly
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A cohort of Korean women with acromegaly had a more pronounced risk for death or developing cancer during 3 years of follow-up compared with men; however, the overall incidence of acromegaly was similar to that of Western populations, according to findings from a database analysis.
“Together with increased risk for diabetes and heart failure among both sexes, malignancy and mortality risk were significantly increased among female acromegalic patients,” Cheol Ryong Ku, MD, PhD, clinical associate professor of endocrinology in the department of internal medicine at Yonsei University College of Medicine in Seoul, South Korea, told Healio. “These results suggest that a precision management plan for comorbidities is necessary for acromegalic patients.”
In a longitudinal, case-control study, Ku and colleagues analyzed the incidence of acromegaly diagnosed in South Korea between 2010 and 2013, using the Korean Health Insurance Review and Assessment claims database (n = 5,497). Researchers then selected incident cases of 718 patients with acromegaly who underwent medical therapy, surgery or radiotherapy within 2 years of diagnosis (407 women; mean age at diagnosis, 46 years; 85.5% underwent surgery) and a randomly selected group of 7,180 adults who underwent appendectomy without a diagnosis of acromegaly during the same period (control cases). Researchers identified comorbidities before, during and 2 years after acromegaly diagnosis and compared comorbidities with controls.
The mean annual incidence rate of acromegaly was 3.57 cases per million. The incidence rate among women was higher vs. men, at 4.06 cases per million vs. 3.09 cases per million. Researchers also observed sex differences in the incidence rate by age; age at peak incidence was 50 to 59 years for women and 40 to 49 years for men.
Malignancies occurred for 61 patients with acromegaly (8.5%) during the study period. Thyroid cancer was the most common malignancy, occurring for 38 adults.
Among people with acromegaly, the overall risk for malignancy was more than twice as high as among controls, with an HR of 2.82 (95% CI, 2.12-3.74). Malignancy risk was higher among women with acromegaly vs. men, with HRs of 3.14 (95% CI, 2.28-4.34) and 2.28 (95% CI, 1.14-3.78), respectively.
Researchers also observed a higher prevalence of diabetes and heart failure among adults with acromegaly vs. controls. During the study period, 51.1% of men and 57% of women with acromegaly developed diabetes. During follow-up, 31 adults in the acromegaly group died. Mortality risk was higher overall for those with acromegaly vs. controls (HR = 1.65; 95% CI, 1.13-2.41) and statistically significant among women (HR = 1.75; 95% CI, 1.07-2.84).
“We found elevated risk of malignancy and mortality, especially in females, and significantly high prevalence of diabetes and heart failure in patients with acromegaly,” the researchers wrote. “The prevalence and risk of acromegaly-related comorbidities were already increased in the ‘pre’-period of acromegaly diagnosis.”
Ku said comorbidities of acromegaly could not be analyzed according to hormonal status or treatment modality, and a multicenter cohort study of Asian adults is necessary to confirm the findings. – by Regina Schaffer
For more information:
Cheol Ryong Ku, MD, PhD, can be reached at the Institute of Endocrine Research, Department of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea; email: cr079@yuhs.ac.
Disclosures: The authors report no relevant financial disclosures.
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