ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Acromegaly is associated with reduced socioeconomic status and more so in female patients: A nationwide population-based study
Jakob Dal 1,2 , Eigil H Nielsen 1 , Ulla Feldt-Rasmussen 3 , Marianne Andersen 4 , Claus Feltoft 5 , Peter Vestergaard 1,2 , Kirstine Stochholm 6 & Jens Otto Jorgensen 6
1Aalborg University Hospital, Endocrinology, Aalborg, Denmark; 2Steno Diabetic Center Northjutland, Aalborg, Denmark; 3 Copenhagen University Hospital, Department of Endocrinology and Metabolism, Rigshospitalet,, Copenhagen, Denmark; 4Odensen University Hospital, Endocrinology, Denmark; 5Herlev Hospital, Endocrinology, Denmark; 6Aarhus University Hospital, Department of Endocrinology and Internal Medicine, Denmark
Context: Acromegaly is a rare and 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, nationwide follow-up study.
Patients and Methods: All incident cases of acromegaly (n = 576) during the period 1997–2010 were included, representing 10.116 years at risk. For every patient, 100 persons were sampled from the general population matched on date of birth and gender (comparison cohort). Cox regression and hazard ratios (HR) or conditional logistic regression with 95% confidence intervals (CI) were used.
Main outcome measures: Annual income, allocation of cash benefits, retirement, cohabitation, separation, parenthood and education level.
Results: The proportion of retirement was significantly increased in patients with acromegaly after the time of diagnosis (HR 1.43, CI95% 1.26–1.62) and also during the 5-year pre-diagnostic period (HR : 1.15, CI95% 1.03–1.28). The utilisation of cash benefits was increased in patients with acromegaly in the period preceding the time of diagnosis. Among patients who maintain a paid job, the annual income was similar to the reference population. Compared with the background population, cohabitation was less prevalent (HR : 0.69, CI : 0.50–0.95) as was parenthood (HR : 0.56, CI : 0.39–0.80), whereas neither educational level (HR: 0.61, CI : 0.35–1.06) nor the prevalence of separation (HR : 1.13, CI : 0.86–1.47) weredifferent in acromegaly. A reduced socioeconomic status was present before the diagnosis of acromegaly. Female gender was associated with a significantly worse socioeconomic status (Table 1).
| After diagnosis | Female | P-value | Male | P-value |
| Mortality | 1.56 (1.27–1.91) | < 0.01 | 1.32 (1.09–1.61) | < 0.01 |
| Retirement | 1.58 (1.33–1.87) | < 0.01 | 1.30 (1.08–1.55) | < 0.01 |
| Education | 0.65 (0.34–1.25) | 0.19 | 0.52 (0.17–1.63) | 0.26 |
| Separation | 1.28 (0.89–1.83) | 0.18 | 0.99 (0.67–1.47) | 0.95 |
| Cohabitaion | 0.62 (0.38–1.00) | 0.05 | 0.76 (0.50–1.16) | 0.20 |
| Parenthood | 0.33 (0.17–0.67) | < 0.01 | 0.74 (0.48–1.12) | 0.16 |
| 5-years pre-diagnosis | ||||
| Retirement | 1.14 (0.98–1.33) | 0.08 | 1.16 (0.99–1.36) | 0.07 |
| Cohabitaion | 0.75 (0.53–1.06) | 0.10 | 1.06 (0.79–1.41) | 0.71 |
| Parenthood | 0.55 (0.34–0.87) | 0.01 | 0.82 (0.60–1.13) | 0.23 |
Conclusion: 1. Socioeconomic status is impaired in patients with acromegaly even before diagnosis. 2. Females and patients without disease remission have significantly worse outcomes. 3. Early diagnosis and effective treatment are essential not least in female patients.
Volume 70
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