Excess mortality in acromegaly

Horm Res. 2007;68 Suppl 5:166-72. doi: 10.1159/000110617. Epub 2007 Dec 10.

Abstract

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 microg/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.

Publication types

  • Review

MeSH terms

  • Acromegaly / blood
  • Acromegaly / complications
  • Acromegaly / mortality*
  • Acromegaly / radiotherapy
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Human Growth Hormone / blood
  • Humans
  • Hypertension / complications
  • Insulin-Like Growth Factor I / metabolism
  • Predictive Value of Tests
  • Radiation Injuries / complications
  • Risk Factors
  • Time Factors

Substances

  • Human Growth Hormone
  • Insulin-Like Growth Factor I