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Pituitary
Published in: Pituitary 4/2023

Open Access 20-05-2023 | Acromegaly

Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly: a systematic review in accordance with PRISMA guidelines

Authors: Tessa N. A. Slagboom, Christa C. van Bunderen, Ralph De Vries, Peter H. Bisschop, Madeleine L. Drent

Published in: Pituitary | Issue 4/2023

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Abstract

Objective

Diagnostic delay is high in acromegaly and leads to increased morbidity and mortality. The aim of this study is to systematically assess the most prevalent clinical signs, symptoms and comorbidities of acromegaly at time of diagnosis.

Design

A literature search (in PubMed, Embase and Web of Science) was performed on November 18, 2021, in collaboration with a medical information specialist.

Methods

Prevalence data on (presenting) clinical signs, symptoms and comorbidities at time of diagnosis were extracted and synthesized as weighted mean prevalence. The risk of bias was assessed for each included study using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

Results

Risk of bias and heterogeneity was high in the 124 included articles. Clinical signs and symptoms with the highest weighted mean prevalence were: acral enlargement (90%), facial features (65%), oral changes (62%), headache (59%), fatigue/tiredness (53%; including daytime sleepiness: 48%), hyperhidrosis (47%), snoring (46%), skin changes (including oily skin: 37% and thicker skin: 35%), weight gain (36%) and arthralgia (34%). Concerning comorbidities, acromegaly patients more frequently had hypertension, left ventricle hypertrophy, dia/systolic dysfunction, cardiac arrhythmias, (pre)diabetes, dyslipidemia and intestinal polyps- and malignancy than age- and sex matched controls. Noteworthy, cardiovascular comorbidity was lower in more recent studies. Features that most often led to diagnosis of acromegaly were typical physical changes (acral enlargement, facial changes and prognatism), local tumor effects (headache and visual defect), diabetes, thyroid cancer and menstrual disorders.

Conclusion

Acromegaly manifests itself with typical physical changes but also leads to a wide variety of common comorbidities, emphasizing that recognition of a combination of these features is key to establishing the diagnosis.
Appendix
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Metadata
Title
Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly: a systematic review in accordance with PRISMA guidelines
Authors
Tessa N. A. Slagboom
Christa C. van Bunderen
Ralph De Vries
Peter H. Bisschop
Madeleine L. Drent
Publication date
20-05-2023
Publisher
Springer US
Keyword
Acromegaly
Published in
Pituitary / Issue 4/2023
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-023-01322-7

Other articles of this Issue 4/2023

Pituitary 4/2023 Go to the issue

OriginalPaper

Health-related quality of life analyses in nonfunctioning pituitary macroadenoma patients identifies at-risk populations

OriginalPaper

Sporadic pituitary adenoma with somatic double-hit loss of MEN1

OriginalPaper

Evaluating the burden of endogenous Cushing’s syndrome using a web-based questionnaire and validated patient-reported outcome measures

OriginalPaper

Postsurgical outcomes of nonfunctioning pituitary adenomas: a patient-level meta-analysis

Review

Efficacy and safety of cavernous sinus medial wall resection in pituitary adenoma surgery: a systematic review and a single-arm meta-analysis

OriginalPaper

Usefulness of a clinicopathological classification in predicting treatment-related outcomes and multimodal therapeutic approaches in pituitary adenoma patients: retrospective analysis on a Portuguese cohort of 129 patients from a tertiary pituitary center
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Obesity Clinical Trial Summary

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