ACROMEGALY - AN EPIDEMIOLOGIC-STUDY

Although morbility and mortality in acromegaly are higher than in the general population, there have been very few previous epidemiological studies. This study tries to answer ''why''. Seventy-four patients aff ected by acromegaly in Vizcaya (Spain) between 1970 and 1989 were cons idered for an epidemiological study. The prevalence of known cases at the end of 1989 was 60 per million inhabitants. The average incidence of newly diagnosed cases was 3.1 per million people per year. Unexpect edly. acromegaly was more frequent in women (n=48) than in men (n=26), with a ratio of 1.8:1. Mean age at diagnosis was significantly higher in women (46.1+/-2.2 yr) than in men (39.5+/-2.2 yr) (p<0.05) There w as a positive correlation between age at diagnosis and the estimated d uration of the disease (r=0.56, p<0.05) and a negative one between age and basal GH serum levels (r=-0.52 p<0.002). The age at diagnosis was significantly higher in patients with invasive tumors (grade III and IV) than in those with enclosed tumors (grade I and II) (47.7+/-1.8 vs 40.1+/-3.3 p<0.05). In general, mortality was higher than the expecte d for the control population (standardized mortality ratio, SMR=3.2, 9 5% confidence Interval. CI=1.55-5.93). However, mortality was higher i n men (SMR=7. 95% CI=2.81-14.4) but not in women (SMR=1.4 95% CI=0.29- 4.17). Concerning the cause of death in men, the SMR of vascular disea se was 10 (95% CI=0.25-55.7) and the SMR of malignant neoplasms was 7. 1 (95% CI=2.31-16.6). In conclusion prevalence and incidence of acrome galy were similar to those previously reported except that we observed a higher prevalence, in women. Mortality was higher in men, due parti cularly to vascular and neoplastic causes.