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Epidemiology of Acromegaly

Acromegaly is a relatively uncommon disease, and studies estimate that its prevalence is between 50 to 70 cases per million people.1 In terms of new cases, these are estimated at an annual incidence of three to four per million, based on this data, approximately 1000 new cases of acromegaly are diagnosed in the United States each year.2,3


Pathophysiology

Acromegaly is characterized by hypersecretion of growth hormone (GH), which is caused by the existence of a secreting pituitary tumor in more than 95% of acromegaly cases. Pituitary tumors are benign adenomas and can be classified according to size (microadenomas being less than 10 mm in diameter and macroadenomas being greater than 10 mm in diameter).3,4 In rare instances, elevated GH levels are caused by extra pituitary disorders. In either situation, hypersecretion of GH in turn causes subsequent hepatic stimulation of insulin-like growth factor-1 (IGF-1).1


The clinical features of acromegaly result from either:

  • Pressure from the pituitary adenoma3
  • Elevated levels of GH and IGF-1, which work independently and in tandem to produce various signs and symptoms associated with acromegaly3

Specifically, cardiovascular, respiratory, and metabolic co-morbidities –– and resultant potential for mortality –– are associated with permanently elevated levels of GH and IGF-1.5



References:
1.
American Association of Clinical Endocrinologists Medical guidelines for clinical practice for the diagnosis and treatment of acromegaly. Endocrine Practice. 2004;10:213-225.
2.
Buehler BR, Henzen CM, de Zulueta MT, Ross RA. Acromegaly and colorectal cancer. J Applied Res. 2004;4:257-260.
3.
Melmed S, Kleinberg D. Anterior pituitary. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, eds. Williams Textbook of Endocrinology. 10th ed. Philadelphia Pa.: WB Saunders Company; 2003:177-260.
4.
Molitch ME. Clinical manifestations of acromegaly. Endocrinol & Metab Clin North Am. 1992;21:597-614.
5.
Melmed S, Casanueva F, Cavagnini F, Chanson P, et al. Consensus statement: Medical management of acromegaly. Eur J Endocrinol. 2005;153:737-740.
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