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  • 1.
    Robèrt, J.
    et al.
    Departments of Endocrinology in Linköping and Norrköping, Linköping University, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Tsatsaris, E.
    Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
    Berinder, K.
    Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Bonelli, L.
    Department of Endocrinology, Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
    Burman, P.
    Department of Endocrinology, Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
    Dahlqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Höybye, C.
    Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Olsson, D.S.
    Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
    Ragnarsson, O.
    Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Göteborg, Sweden.
    Vouzouneraki, Konstantina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Åkerman, A.-K.
    Department of Internal Medicine, Örebro University Hospital, Örebro, Sweden; Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ekman, B.
    Departments of Endocrinology in Linköping and Norrköping, Linköping University, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Edén Engström, B.
    Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
    Establishing a valid cohort of patients with acromegaly by combining the national patient register with the Swedish pituitary register2023In: Journal of Endocrinological Investigation, ISSN 0391-4097, E-ISSN 1720-8386Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to establish a valid national cohort of patients diagnosed with acromegaly by combining data from the general National Patient Register (NPR) and the disease-specific Swedish Pituitary Register (SPR).

    Methods: Patients ≥ 18 years of age at diagnosis of acromegaly reported from 1991 to 2018 who were registered in the NPR and/or SPR were included. The diagnosis of acromegaly was considered correct for patients identified in both registers or confirmed through chart review. Medical records were reviewed in two of Sweden´s six health care regions if the patient was reported only in the NPR. An algorithm for the NPR, with criteria requiring multiple diagnosis registrations and tumour and/or surgery codes, was constructed to reduce the number of patients to review in the remaining four regions.

    Results: A total of 1866 patients were identified. Among these, 938 were reported in both registers. After application of the algorithm and chart review, the diagnosis was confirmed for 83 of the 906 patients found only in the NPR. Among 22 patients only registered in the SPR, a review of medical records confirmed acromegaly in 13. This resulted in a total of 1034 cases with acromegaly during the study period. The incidence rate of acromegaly in Sweden 1991–2018 was calculated to 4.0/million/year in the entire population and 5.1/million/year among subjects ≥ 18 years of age.

    Conclusion: The combination of the SPR and NPR established a valid cohort of patients diagnosed with acromegaly and increased the estimated incidence in Sweden.

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  • 2.
    Vouzouneraki, Konstantina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Sundsvalls sjukhus, Sweden.
    Dahlqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Norrlands universitetssjukhus, Sweden.
    Sömnapné vanligt vid akromegali – även före akromegalidiagnosen2018In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, no 41, article id FDFXArticle in journal (Other academic)
  • 3.
    Vouzouneraki, Konstantina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Esposito, Daniela
    Mukka, Sebastian
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Granfeldt, Daniel
    Ragnarsson, Oskar
    Dahlqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Olsson, Daniel S.
    Carpal tunnel syndrome in acromegaly: a nationwide study2021In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 184, no 2, p. 209-216Article in journal (Refereed)
    Abstract [en]

    Objective: Carpal tunnel syndrome (CTS) is common in patients with acromegaly, with a reported prevalence of 19–64%.We studied CTS in a large national cohort of patients with acromegaly and the temporal relationship between thetwo diagnoses.

    Design: Retrospective, nationwide, cohort study including patients diagnosed with acromegaly in Sweden, 2005–2017,identified in the Swedish Healthcare Registries.

    Methods: CTS (diagnosis and surgery in specialised healthcare) was analysed from 8.5 years before the diagnosis ofacromegaly until death or end of the study. Standardised incidence ratios (SIRs) with 95% CIs were calculated for CTSwith the Swedish population as reference.

    Results: The analysis included 556 patients with acromegaly (50% women) diagnosed at mean (s.d.) age 50.1 (15.0)years. During the study period, 48 patients were diagnosed with CTS and 41 patients underwent at least one CTSsurgery. In the latter group, 35 (85%) were operated for CTS before the acromegaly diagnosis; mean interval (range)2.2 (0.3–8.5) years and the SIR for having CTS surgery before the diagnosis of acromegaly was 6.6 (4.8–8.9). Womenwith acromegaly had a higher risk for CTS than men (hazard ratio: 2.5, 95% CI: 1.3–4.7).

    Conclusions: Patients with acromegaly had a 6-fold higher incidence for CTS surgery before the diagnosis of acromegalycompared with the general population. The majority of patients with both diagnoses were diagnosed with CTS priorto acromegaly. Increased awareness of signs of acromegaly in patients with CTS might help to shorten the diagnosticdelay in acromegaly, especially in women.

  • 4.
    Vouzouneraki, Konstantina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Franklin, Karl A
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Forsgren, Maria
    Wärn, Maria
    Persson, Jenny Tiberg
    Wik, Helena
    Dahlgren, Christina
    Nilsson, Ann-Sofie
    Alkebro, Caroline
    Burman, Pia
    Erfurth, Eva-Marie
    Wahlberg, Jeanette
    Åkerman, Anna-Karin
    Høbye, Charlotte
    Ragnarsson, Oskar
    Edén Engström, Britt
    Dahlqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Temporal relationship of sleep apnea and acromegaly: a nationwide study2018In: Endocrine, ISSN 1355-008X, E-ISSN 1559-0100, Vol. 62, no 2, p. 456-463Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Patients with acromegaly have an increased risk of sleep apnea, but reported prevalence rates vary largely. Here we aimed to evaluate the sleep apnea prevalence in a large national cohort of patients with acromegaly, to examine possible risk factors, and to assess the proportion of patients diagnosed with sleep apnea prior to acromegaly diagnosis.

    Methods: Cross-sectional multicenter study of 259 Swedish patients with acromegaly. At patients' follow-up visits at the endocrine outpatient clinics of all seven university hospitals in Sweden, questionnaires were completed to assess previous sleep apnea diagnosis and treatment, cardiovascular diseases, smoking habits, anthropometric data, and S-IGF-1 levels. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale. Patients suspected to have undiagnosed sleep apnea were referred for sleep apnea investigations.

    Results: Of the 259 participants, 75 (29%) were diagnosed with sleep apnea before the study start. In 43 (57%) of these patients, sleep apnea had been diagnosed before the diagnosis of acromegaly. After clinical assessment and sleep studies, sleep apnea was diagnosed in an additional 20 patients, yielding a total sleep apnea prevalence of 37%. Higher sleep apnea risk was associated with higher BMI, waist circumference, and index finger circumference. Sleep apnea was more frequent among patients with S-IGF-1 levels in the highest quartile.

    Conclusion: Sleep apnea is common among patients with acromegaly, and is often diagnosed prior to their acromegaly diagnosis. These results support early screening for sleep apnea in patients with acromegaly and awareness for acromegaly in patients with sleep apnea.

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