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Sex differences in mortality in patients with acromegaly: a nationwide cohort study in Korea

 Jiwon Kim  ;  Namki Hong  ;  Jimi Choi  ;  Ju Hyung Moon  ;  Eui Hyun Kim  ;  Jae Won Hong  ;  Eun Jig Lee  ;  Sin Gon Kim  ;  Cheol Ryong Ku 
 EUROPEAN JOURNAL OF ENDOCRINOLOGY, Vol.189(2) : 225-234, 2023-08 
Journal Title
Issue Date
Acromegaly* / complications ; Cohort Studies ; Diabetes Mellitus* / epidemiology ; Female ; Humans ; Male ; Neoplasms* / complications ; Republic of Korea / epidemiology ; Risk Factors ; Sex Characteristics ; Sleep Apnea, Obstructive*
Asia ; acromegaly ; mortality ; nationwide ; women
Objective: The results of previous studies on sex differences in mortality and comorbidities among patients with acromegaly are diverse. We assessed sex differences in mortality and the risk of complications in patients with acromegaly.

Methods: We included 1884 patients with acromegaly with 1:50 age- and sex-matched 94 200 controls using the Korean nationwide claims database from 2009 to 2019.

Results: During the median 5.51 years of follow-up, the acromegaly group had higher all-cause mortality than the control group (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.38-2.19), with higher risk in women than men (HR 2.17 vs 1.36). The most common cause of death was malignancy. Women with acromegaly aged ≥50 years exhibited significantly higher mortality than men with acromegaly aged ≥50 years (HR 1.74 vs 0.96). In a treatment subgroup other than surgery alone, women had a higher risk of mortality than men (HR 2.82 vs 1.58). Sex differences in mortality among patients with acromegaly remained equal after adjustment for the Charlson Comorbidity Index (CCI), socioeconomic status (SES), body mass index (BMI), alcohol consumption, smoking, fasting plasma glucose, creatinine, and total cholesterol. Patients with acromegaly had elevated risks of developing major adverse cardiovascular events (MACE), atrial fibrillation, obstructive sleep apnea (OSA), diabetes mellitus (DM), end-stage renal disease (ESRD), Parkinson's disease (PD), depression, and malignancy than age- and sex-matched controls, with a higher risk of OSA and DM in women than men.

Conclusions: The risk of mortality and complications in patients with acromegaly compared to age- and sex-matched controls was higher in women than in men.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Cheol Ryong(구철룡) ORCID logo https://orcid.org/0000-0001-8693-9630
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Kim, Jiwon(김지원)
Moon, Ju Hyung(문주형)
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
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