TY - JOUR
T1 - Disease Control and Gender Predict the Socioeconomic Effects of Acromegaly
T2 - A Nationwide Cohort Study
AU - Dal, Jakob
AU - Nielsen, Eigil H
AU - Rasmussen, Ulla-Feldt
AU - Andersen, Marianne
AU - Feltoft, Claus L
AU - Vestergaard, Peter
AU - Stochholm, Kirstine
AU - Jørgensen, Jens Otto L
N1 - © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2020/9/1
Y1 - 2020/9/1
N2 - CONTEXT: Acromegaly is an insidious disease associated with severe somatic morbidity but data on socioeconomic status are scarce.OBJECTIVE: To study the socioeconomic status in acromegaly in a population-based follow-up study.METHODS: All incident cases of acromegaly (n = 576) during the period 1977-2010 were included. For every patient, 100 persons were sampled from the general population matched for date of birth and gender (comparison cohort). Cox regression and hazard ratios (HR), conditional logistic regression and linear regression with 95% confidence intervals (CI) were used.OUTCOME MEASURES: Retirement, social security benefit, annual income, cohabitation, separation, parenthood and educational level.RESULTS: The proportion of retired individuals was significantly higher in patients with acromegaly after the time of diagnosis (HR, 1.43; 95% CI, 1.26-1.62) and also during the 5-year pre-diagnostic period (HR, 1.15; 95% CI, 1.03-1.28). More individuals with acromegaly received social security benefit compared with the comparison cohort during the initial period after the time of diagnosis. Among patients who maintained a job, the annual income was similar to the comparison cohort. Compared with the background population, cohabitation was lower (HR, 0.69; 95% CI, 0.50-0.95) as was parenthood (HR, 0.56; 95% CI, 0.39-0.80), whereas neither educational level (HR, 0.61; 95% CI, 0.35-1.06) nor separation (HR, 1.13; 95% CI, 0.86-1.47) were different. Female gender and insufficient disease control were associated with a significantly worse socioeconomic status.CONCLUSIONS: 1) Socioeconomic status is impaired in patients with acromegaly even before a diagnosis of acromegaly. 2) Females and patients without disease remission have worse outcomes. 3) Early diagnosis and effective treatment of acromegaly could be important factors in mitigating the negative impact on socioeconomic factors.
AB - CONTEXT: Acromegaly is an insidious disease associated with severe somatic morbidity but data on socioeconomic status are scarce.OBJECTIVE: To study the socioeconomic status in acromegaly in a population-based follow-up study.METHODS: All incident cases of acromegaly (n = 576) during the period 1977-2010 were included. For every patient, 100 persons were sampled from the general population matched for date of birth and gender (comparison cohort). Cox regression and hazard ratios (HR), conditional logistic regression and linear regression with 95% confidence intervals (CI) were used.OUTCOME MEASURES: Retirement, social security benefit, annual income, cohabitation, separation, parenthood and educational level.RESULTS: The proportion of retired individuals was significantly higher in patients with acromegaly after the time of diagnosis (HR, 1.43; 95% CI, 1.26-1.62) and also during the 5-year pre-diagnostic period (HR, 1.15; 95% CI, 1.03-1.28). More individuals with acromegaly received social security benefit compared with the comparison cohort during the initial period after the time of diagnosis. Among patients who maintained a job, the annual income was similar to the comparison cohort. Compared with the background population, cohabitation was lower (HR, 0.69; 95% CI, 0.50-0.95) as was parenthood (HR, 0.56; 95% CI, 0.39-0.80), whereas neither educational level (HR, 0.61; 95% CI, 0.35-1.06) nor separation (HR, 1.13; 95% CI, 0.86-1.47) were different. Female gender and insufficient disease control were associated with a significantly worse socioeconomic status.CONCLUSIONS: 1) Socioeconomic status is impaired in patients with acromegaly even before a diagnosis of acromegaly. 2) Females and patients without disease remission have worse outcomes. 3) Early diagnosis and effective treatment of acromegaly could be important factors in mitigating the negative impact on socioeconomic factors.
KW - Acromegaly
KW - socioeconomic factor
KW - gender
KW - IGF-I
KW - hypopituitarism
U2 - 10.1210/clinem/dgaa405
DO - 10.1210/clinem/dgaa405
M3 - Journal article
C2 - 32593172
SN - 0021-972X
VL - 105
SP - 2975
EP - 2982
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
IS - 9
ER -