Epidemiology of acromegaly in Ecuador

Objectives To assess the epidemiology of acromegaly in the city of Guayaquil, Ecuador, and to compare our results to those reported in the literature. Patients, material and methods An analysis was made of retrospective and prospective data from all patients with acromegaly attending endocrinology clinics at the 4 main hospitals of the public health network of Guayaquil from January 2000 to December 2014. Age at diagnosis, estimated delay in diagnosis, imaging studies of pituitary gland, basal growth hormone (GH) level, GH after an oral glucose tolerance test (OGTT-GH), and serum levels of insulin-like growth factor 1 (IGF-1) were recorded. Incidence and prevalence of the disease were estimated using information from the 2010 census of population and housing. Results Forty-eight cases were recorded in the study period in 17 males (35.4%) and 31 females (64.5%); M/F ratio = 1.8:1. Mean age at diagnosis was 47.3 ± 16.8 years (range 18–86). Delay in diagnosis was 7.3 ± 6.3 years (range 1–30). Mean age at diagnosis was 47.9 ± 18.2 years in males and 46.3 ± 15.8 years in females. Delay in diagnosis was 10.2 ± 7.9 and 5.7 ± 3.9 years in males and females, respectively. Prevalence of acromegaly is 18.7 cases per million inhabitants, and incidence of acromegaly 1.3 cases per million people per year. Conclusions Acromegaly predominates in females, and is diagnosed in the fourth decade with a delay of approximately 8 years, usually even longer in males. Incidence and prevalence are lower than reported in international series. The disease is underdiagnosed and underreported in Ecuador.