The Austrian Acromegaly Registry is an initiative of the Austrian Society for Endocrinology and Metabolism. This database includes 607 patients (54% females) followed in twelve centers. Mean treatment period is 10.7 years (range 050 years), the total number of patient-years is 6470. Here we report gender-specific differences in the presentation, therapy and biochemical control of acromegaly in patients included in this registry.
Mean age at diagnosis was 46.7 years for females and 44.1 years for males. Younger age at diagnosis of acromegaly and male sex were associated with larger tumour size (P=0.001). Co-morbidities were found to be more prevalent in females, where hypertension was observed in 50% of the cases (45% in males), diabetes in 29% (24% in males) and both hypertension and diabetes in 20% (as compared to 15% in males). Mortality rates were 2.9% in males and 3.3% in females, but mean age at death was 63 years for men and 73 years for women.
Data on biochemical control were collected in 476 patients with acromegaly and disease duration longer than 9 months, who were last visited between 2003 and 2014. Disease control was evaluated by GH less than 1.0 ng/ml during an oral glucose suppression test and/or normal age- and gender-specific IGF-1. These outcome data were available for 414 patients, 55% were females. At the last visit, 71% of the patients were biochemically controlled. Female gender was a significant predictor of biochemical control (P=0.011), as 77% of females but only 64% of males showed normal IGF-1 and/or GH nadir during OGTT. Fifty percent of females and 62% of males with biochemically controlled disease receive concomitant medical therapy for acromegaly.
In summary, male patients with acromegaly are diagnosed at younger age and have larger tumors. Although the prevalence and co-morbidities of acromegaly are higher in females, both biochemical control of the disease and life expectancy are remarkably better in women.