Racial Disparities in Acromegaly and Cushing's Disease: A Referral Center Study in 241 Patients

Area of Science:

• Endocrinology
• Neurosurgery
• Health Disparities Research

Background:

• Acromegaly (ACM) and Cushing's disease (CD) arise from hormone-secreting pituitary adenomas.
• Understanding racial impacts on these conditions is crucial for equitable care.

Purpose of the Study:

• To investigate racial differences in the presentation and postoperative outcomes of adult patients with ACM and CD.
• To compare the racial distribution of patients with ACM and CD to the general population.

Main Methods:

• Retrospective analysis of 241 patients with ACM or CD treated at a high-volume pituitary center.
• Evaluation of racial distribution against US census data.
• Comparison of clinical presentation and postoperative outcomes between Black and White patients.

Main Results:

• Black patients were underrepresented in ACM and CD cohorts compared to the metropolitan population.
• Black patients with ACM presented more frequently with headaches or incidentalomas and had higher rates of diabetes.
• While biochemical remission rates were similar, Black patients with CD had higher rates of hypopituitarism and macroadenomas.

Conclusions:

• Significant racial disparities in presentation and characteristics were observed in ACM and CD.
• Findings suggest potential for delayed or missed diagnoses in Black patients with ACM.
• Further large-scale studies are warranted to validate these racial disparities in pituitary adenoma care.