J Korean Soc Endocrinol.  1994 Dec;9(4):290-306.

Clinical Characteristics of Acromegalic Patients in Korea

• Yang IM

Abstract

There was no nation-wide survey for acromegaly in Korea. To elucidate the incidence, clinical characteristics and the current status of diagnosis and treatment of acromegaly in Korea during the period from January 1988 to December 1992, we analyzed the survey protocols of 279 acromegalic patients which had been recorded in 24 university hospitals and 2 general hospitals. The estimated incidence was 1.4 per million individuals. The number of patients is not different in sex and the mean age was 42 years. The half of the patients were diagnosed at their forties and fifties. Enlargement of acral part is the most common sysptom(75%) and the next is dyspnea(69%) followed by headache(54%), excessive sweating(37%), diabetes mellitus(36%), visual disturbance(24%), hypertension(20%). The frequency of lumbar pain, visual disturbance and diabetes mellitus were higher, but that of hirsutism was lower than those reported in weatern studies. Oral glucose tolerance test was performed in only 46% of patients. Thirty four percent of them were diagnosed to have diabetes mellitus and 18% showed glucose intolerance. Forty two percent of patients had hyperphosphatemia and 36% of patients had an increased alkaline phosphatase activity. The GH suppression test by glucose was performed in only 56% of patients. The TRH or LHRH stimulation test was performed in only 29% and 14% of patients, respectively. The paradoxical response to TRH or LHRH was found in 53% and 33% of them, respectively. The somatostatin suppression test was carried out in only 17% of patients and the GH level was suppressed below 5 ng/ml in 49% of them. Bromocriptine suppression test was done in only 21% of patients and the GH level was normalized in 34.5% of them. To identify the location and size of pituitary tumor, computed tomography or magnetic resonance imaging was performed in only 52% of patients, and 78% of them had macroadenoma. About 10% of patients were not treated at all and 24% and 2% of patients were treated by only medication and radiotherapy, respectively. Normalization of GH level below 5 ng/ml was achieved in only 16.8% of patients who were considered to be cured completely after treatment. These data suggest that the incidence of acromegaly is relatively lower that that of european countries, and there are differences in the frequencies of clinical manifestations in Korean acromegalics. This survey also indicates that some essential diagnostic tests including endocrinologic evaluation were not performed in many cases, and the complete cure rate is significantly lower than that of western countries.

MeSH Terms

Acromegaly
Alkaline Phosphatase
Bromocriptine
Diabetes Mellitus
Diagnosis
Diagnostic Tests, Routine
Glucose
Glucose Intolerance
Glucose Tolerance Test
Gonadotropin-Releasing Hormone
Hirsutism
Hospitals, General
Hospitals, University
Humans
Hyperphosphatemia
Incidence
Korea*
Magnetic Resonance Imaging
Pituitary Neoplasms
Radiotherapy
Somatostatin
Alkaline Phosphatase
Bromocriptine
Glucose
Gonadotropin-Releasing Hormone
Somatostatin