title: Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--meta-analysis and systematic review.
abstract: BACKGROUND
  Acromegaly is a quite rare chronic disease caused by the increased secretion of growth hormone (GH) and subsequently insulin - like growth factor 1. Although cardiovascular diseases remains the most common cause of mortality among acromegalic patients, increased prevalence of malignant and benign neoplasms remains a matter of debate. The aim of this study is to evaluate the risk of thyroid nodular disease (TND) and thyroid cancer in patients with acromegaly.
  
  
  METHODS
  PubMed, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched to identify studies containing. Random-effects model was used to calculate pooled odds ratios and risk ratios of TND in acromegaly. Studies which not included control groups were systematically reviewed.
  
  
  RESULTS
  TND was more frequent in acromegaly than in control groups (OR = 6.9, RR = 2.1). The pooled prevalence of TND was 59.2%. Also thyroid cancer (TC) proved to be more common in acromegalic patients (OR = 7.5, RR = 7.2), prevalence was 4.3%. The pooled rate of malignancy (calculated per patient) was equal to 8.7%.
  
  
  CONCLUSIONS
  This study confirms that both TND and TC occur significantly more often in acromegalic patients than in general population. These results indicate that periodic thyroid ultrasound examination and careful evaluation of eventual lesions should be an important part of follow-up of patients with acromegaly.
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Kosma
authors.initials: K
authors.lastname: Wolinski
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Czarnywojtek
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Ruchala
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000473:pathology; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D012307:Risk Factors; D016606:Thyroid Nodule / Q000209:etiology* / Q000473:pathology