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High prevalence of biochemical acromegaly in primary care patients with elevated IGF-1 levels

H J Schneider1, C Sievers, B Saller

  • 1Medizinische Klinik - Innenstadt, Ludwig-Maximilian-University, Munich, Germany. harald.schneider@med.uni-muenchen.de

Clinical Endocrinology
|February 21, 2008
PubMed

Insights

This study found a high prevalence of undiagnosed acromegaly in primary care settings. Early detection of acromegaly is crucial due to delayed diagnoses and the disease

Area of Science:

  • Endocrinology
  • Epidemiology
  • Primary Care Medicine

Background:

  • Acromegaly, a rare endocrine disorder, is often diagnosed late due to subtle or unrecognized symptoms.
  • Current estimates suggest a prevalence of 40-125 cases per million people.
  • The proportion of individuals with elevated Insulin-like Growth Factor 1 (IGF-1) levels who actually have acromegaly remains unclear.

Purpose of the Study:

  • To determine the prevalence of acromegaly within a primary care population.
  • To investigate the diagnostic yield of screening for elevated IGF-1 levels in primary care.

Main Methods:

  • A cross-sectional epidemiological study (DETECT study) involving 6773 unselected adult patients.
  • Measurement of IGF-1 levels in all participants.
  • Endocrine evaluation for patients with IGF-1 levels exceeding 2 age-dependent standard deviations (SDS).

Main Results:

  • Out of 125 patients with elevated IGF-1, acromegaly was excluded in 42 and results were indeterminate in 76.
  • Two new cases of acromegaly with pituitary adenomas were diagnosed.
  • One known case of florid acromegaly was identified.
  • Four patients with biochemical acromegaly declined further investigation.
  • The calculated prevalence of acromegaly in this cohort was 1034 per million.

Conclusions:

  • The study indicates a significantly higher prevalence of undiagnosed acromegaly in primary care than previously estimated.
  • Acromegaly appears to be substantially underdiagnosed.
  • Emphasizes the critical need for improved detection strategies in primary care settings.
Abstract

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