title: Increased prevalence of acromegaly in a highly polluted area.
abstract: OBJECTIVE
  Despite the contribution of national registries and population-based reports, data concerning the epidemiology of acromegaly is scanty. In addition, the role of the environmental context has not been investigated.
  
  
  METHODS
  Epidemiology of acromegaly was studied in the province of Messina (Sicily, Italy), focusing on the influence of environmental factors.
  
  
  METHODS
  Four zones, characterized by different degrees of exposition to environmental toxins due to industrial pollution, were identified in the province: area A (76,338 inhabitants), area B (287,328 inhabitants), area C (243,381 inhabitants), and area D (47,554 inhabitants) at low, middle-low, middle, and high industrial density respectively. We identified all acromegalics who were born and resided in the province of Messina, among patients either referred to our endocrine unit or referred elsewhere but recorded in the archives of the provincial healthcare agency.
  
  
  RESULTS
  In the province of Messina, we found 64 patients (2 in area A, 24 in area B, 28 in area C, and 10 in area D). Macroadenomas were 60%, the male/female ratio was 1, and mean age at diagnosis (±s.e.m.) was 45.4±1.6 years. Overall, prevalence was 97 c.p.m. in the province (26 c.p.m. in area A, 84 c.p.m. in area B, 115 c.p.m. in area C, and 210 c.p.m. in area D). Risk ratio (RR), calculated in every area assuming area A as a reference, showed an increased risk of developing acromegaly in people residing in area D (RR=8.03; P<0.0014).
  
  
  CONCLUSIONS
  This study confirms the prevalence of acromegaly reported recently. The increased risk of developing this disease in area D suggests that the pathogenetic role of environmental context needs to be better evaluated.
authors.affiliation: Section of Endocrinology, Department of Medicine and Pharmacology, University of Messina, Messina, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cannavò
authors.forename: F
authors.initials: F
authors.lastname: Ferraù
authors.forename: M
authors.initials: M
authors.lastname: Ragonese
authors.forename: L
authors.initials: L
authors.lastname: Curtò
authors.forename: M L
authors.initials: ML
authors.lastname: Torre
authors.forename: M
authors.initials: M
authors.lastname: Magistri
authors.forename: A
authors.initials: A
authors.lastname: Marchese
authors.forename: A
authors.initials: A
authors.lastname: Alibrandi
authors.forename: F
authors.initials: F
authors.lastname: Trimarchi
mesh_terms: D000172:Acromegaly / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D004787:Environmental Pollution / Q000009:adverse effects*; D005260:Female; D005843:Geography; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence