OBJECTIVE The results of previous studies on sex differences in mortality and comorbidities among patients with acromegaly are diverse. We assessed sex differences in mortality and the risk of complications in patients with acromegaly. METHODS We included 1884 patients with acromegaly with 1:50 age- and sex-matched 94 200 controls using the Korean nationwide claims database from 2009 to 2019. RESULTS During the median 5.51 years of follow-up, the acromegaly group had higher all-cause mortality than the control group (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.38-2.19), with higher risk in women than men (HR 2.17 vs 1.36). The most common cause of death was malignancy. Women with acromegaly aged ≥50 years exhibited significantly higher mortality than men with acromegaly aged ≥50 years (HR 1.74 vs 0.96). In a treatment subgroup other than surgery alone, women had a higher risk of mortality than men (HR 2.82 vs 1.58). Sex differences in mortality among patients with acromegaly remained equal after adjustment for the Charlson Comorbidity Index (CCI), socioeconomic status (SES), body mass index (BMI), alcohol consumption, smoking, fasting plasma glucose, creatinine, and total cholesterol. Patients with acromegaly had elevated risks of developing major adverse cardiovascular events (MACE), atrial fibrillation, obstructive sleep apnea (OSA), diabetes mellitus (DM), end-stage renal disease (ESRD), Parkinson's disease (PD), depression, and malignancy than age- and sex-matched controls, with a higher risk of OSA and DM in women than men. CONCLUSIONS The risk of mortality and complications in patients with acromegaly compared to age- and sex-matched controls was higher in women than in men.

中文翻译：

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肢端肥大症患者死亡率的性别差异：韩国的一项全国性队列研究。

目的 先前关于肢端肥大症患者死亡率和合并症的性别差异的研究结果各不相同。我们评估了肢端肥大症患者死亡率和并发症风险的性别差异。方法 我们使用 2009 年至 2019 年韩国全国索赔数据库纳入了 1884 名肢端肥大症患者以及 1:50 年龄和性别匹配的 94 200 名对照者。 结果 在中位 5.51 年的随访期间，肢端肥大症组的全因死亡率较高死亡率高于对照组（风险比 [HR] 1.74，95% 置信区间 [CI] 1.38-2.19），女性风险高于男性（HR 2.17 vs 1.36）。最常见的死亡原因是恶性肿瘤。年龄≥50岁肢端肥大症女性的死亡率显着高于年龄≥50岁肢端肥大症男性（HR 1.74 vs 0.96）。在除单纯手术之外的治疗亚组中，女性的死亡风险高于男性（HR 2.82 vs 1.58）。在调整查尔森合并症指数（CCI）、社会经济状况（SES）、体重指数（BMI）、饮酒、吸烟、空腹血糖、肌酐和总胆固醇后，肢端肥大症患者死亡率的性别差异仍然相同。肢端肥大症患者发生主要不良心血管事件（MACE）、心房颤动、阻塞性睡眠呼吸暂停（OSA）、糖尿病（DM）、终末期肾病（ESRD）、帕金森病（PD）、抑郁症和与年龄和性别匹配的对照组相比，女性患 OSA 和 DM 的风险高于男性。结论 与年龄和性别匹配的对照相比，肢端肥大症患者的死亡率和并发症风险，女性高于男性。