{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:53:05Z","timestamp":1780649585363,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,27]],"date-time":"2013-04-27T00:00:00Z","timestamp":1367020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate demographic data and quality of care of patients with acromegaly in Canada and their evolution over time and secondly, to evaluate predictors of co\u2010morbidities and treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and patients<\/jats:title>\n                    <jats:p>\n                      Retrospective analyses of clinical, biochemical and treatment outcome data of 649 patients with acromegaly (males: 50\u00b77%) followed from 1980 to 2010 (mean 10\u00b72\u00a0years,\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      13\u00b77) in eight tertiary care centres from six Canadian provinces.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In comparison to 1980\u20131994, the number of patients referred with acromegaly in the last 15\u00a0years was higher with female preponderance (52\u00b78%\n                      <jats:italic>vs<\/jats:italic>\n                      41\u00b74%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00\u00b701) and an older age at diagnosis (46\u00b74\u00a0\u00b1\u00a014\n                      <jats:italic>vs<\/jats:italic>\n                      41\u00b73\u00a0\u00b1\u00a012\u00a0years,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00\u00b70001). Diabetes was present in 28%, hypertension in 37% and sleep apnoea in 33% of cases. Pretreatment\n                      <jats:styled-content style=\"fixed-case\">IGF<\/jats:styled-content>\n                      \u20101 levels, but not\n                      <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>\n                      levels were significant predictors of diabetes (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00\u00b70002) and hypertension (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00\u00b70001). Eighty\u2010nine per cent of patients underwent pituitary surgery, 64\u00b75% had medical therapy and 22% received radiotherapy. Radiotherapy was less utilized in the past 15\u00a0years (16%\n                      <jats:italic>vs<\/jats:italic>\n                      45%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00\u00b70001). Multimodal therapy achieved remission or control of acromegaly in 70% of patients. Patients in remission or disease control had lower initial random\n                      <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00\u00b704) and\n                      <jats:styled-content style=\"fixed-case\">IGF<\/jats:styled-content>\n                      \u20101 levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00\u00b70001). Hypopituitarism was present in 23% of patients and cancer in 8\u00b75%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      There was an increase over time of referral for acromegaly management with female predilection. Initial higher\n                      <jats:styled-content style=\"fixed-case\">IGF<\/jats:styled-content>\n                      \u20101, but not\n                      <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>\n                      levels, were predictive of co\u2010morbidities and persistent active disease after treatment. Disease remission or control was attained in 70% of patients utilizing multimodal therapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.12112","type":"journal-article","created":{"date-parts":[[2012,11,28]],"date-time":"2012-11-28T20:43:04Z","timestamp":1354135384000},"page":"79-85","source":"Crossref","is-referenced-by-count":36,"title":["Emerging trends in the diagnosis and treatment of acromegaly in Canada"],"prefix":"10.1111","volume":"79","author":[{"given":"Sophie","family":"Vallette","sequence":"first","affiliation":[{"name":"CHUM University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Ezzat","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"Chik","sequence":"additional","affiliation":[{"name":"University of Alberta Edmonton AB 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