期刊
CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY
卷 28, 期 4, 页码 419-426出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MED.0000000000000650
关键词
acromegaly; age; comorbidities; diabetes; sex; growth hormone-secreting adenoma; pegvisomant; somatostatin receptor ligands; transsphenoidal surgery
Patients with acromegaly often experience a significant delay between the onset of symptoms and diagnosis, with women and younger patients experiencing longer delays. Comorbidities usually improve after treatment except for irreversible osteoarticular structural changes. Early diagnosis and personalized care are crucial for better management of the condition.
Purpose of review Discuss recent literature regarding clinical manifestations and comorbidities in acromegaly, with focus on early diagnosis and customized care. Recent findings The mean interval between onset of clinical manifestations and diagnosis is currently 3-5 years. Women, especially younger than 50 years of age, experience longer delays, have lower insulin-like growth factor 1 (IGF-1) levels and larger tumors than men. Development of comorbidities usually precedes the diagnosis and is influenced by age, sex, and biochemical disease activity. Comorbidities other than irreversible osteoarticular structural changes usually improve after acromegaly treatment. In patients with diabetes, the course of hyperglycemia not only depends on biochemical control but also on specific acromegaly therapies. Quality of life is influenced by sex, as well as by acromegaly symptoms, biochemical activity, and treatment. Quality of life remains lower than general population despite biochemical remission. Early diagnosis can be achieved by suspecting acromegaly based on suggestive clinical scenarios rather than obvious changes in appearance. Personalized care entails a proactive multidisciplinary approach to identify and treat comorbidities while carefully monitoring the effects of acromegaly treatment.
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