Disease Control and Gender Predict the Socioeconomic Effects of Acromegaly: A Nationwide Cohort Study.
Acromegaly
/ economics
Adolescent
Adult
Aged
Aged, 80 and over
Case-Control Studies
Child
Cohort Studies
Denmark
/ epidemiology
Educational Status
Female
Follow-Up Studies
Humans
Income
/ statistics & numerical data
Male
Middle Aged
Parents
/ psychology
Patient Outcome Assessment
Registries
Retirement
/ economics
Self Efficacy
Self-Management
/ economics
Sex Factors
Social Class
Socioeconomic Factors
Young Adult
Acromegaly
IGF-I
gender
hypopituitarism
socioeconomic factor
Journal
The Journal of clinical endocrinology and metabolism
ISSN: 1945-7197
Titre abrégé: J Clin Endocrinol Metab
Pays: United States
ID NLM: 0375362
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
07
04
2020
accepted:
20
06
2020
pubmed:
28
6
2020
medline:
25
2
2021
entrez:
28
6
2020
Statut:
ppublish
Résumé
Acromegaly is an insidious disease associated with severe somatic morbidity but data on socioeconomic status are scarce. To study the socioeconomic status in acromegaly in a population-based follow-up study. 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. Retirement, social security benefit, annual income, cohabitation, separation, parenthood and educational level. 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. 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.
Identifiants
pubmed: 32593172
pii: 5864154
doi: 10.1210/clinem/dgaa405
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.