title: Epidemiology of acromegaly in Ecuador.
abstract: OBJECTIVE
  To assess the epidemiology of acromegaly in the city of Guayaquil, Ecuador, and to compare our results to those reported in the literature.
  
  
  METHODS
  An analysis was made of retrospective and prospective data from all patients with acromegaly attending endocrinology clinics at the 4 main hospitals of the public health network of Guayaquil from January 2000 to December 2014. Age at diagnosis, estimated delay in diagnosis, imaging studies of pituitary gland, basal growth hormone (GH) level, GH after an oral glucose tolerance test (OGTT-GH), and serum levels of insulin-like growth factor 1 (IGF-1) were recorded. Incidence and prevalence of the disease were estimated using information from the 2010 census of population and housing.
  
  
  RESULTS
  Forty-eight cases were recorded in the study period in 17 males (35.4%) and 31 females (64.5%); M/F ratio=1.8:1. Mean age at diagnosis was 47.3±16.8 years (range 18-86). Delay in diagnosis was 7.3±6.3 years (range 1-30). Mean age at diagnosis was 47.9±18.2 years in males and 46.3±15.8 years in females. Delay in diagnosis was 10.2±7.9 and 5.7±3.9 years in males and females, respectively. Prevalence of acromegaly is 18.7 cases per million inhabitants, and incidence of acromegaly 1.3 cases per million people per year.
  
  
  CONCLUSIONS
  Acromegaly predominates in females, and is diagnosed in the fourth decade with a delay of approximately 8 years, usually even longer in males. Incidence and prevalence are lower than reported in international series. The disease is underdiagnosed and underreported in Ecuador.
authors.affiliation: Servicio de Endocrinología, Hospital Docente Policía Nacional N.° 2, Guayaquil, Ecuador. Electronic address: enrique_lopezg57@hotmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: López Gavilanez
authors.affiliation: Servicio de Endocrinología, Hospital Docente Policía Nacional N.° 2, Guayaquil, Ecuador.
authors.forename: Kempis
authors.initials: K
authors.lastname: Guerrero Franco
authors.affiliation: Servicio de Endocrinología, Hospital L. Vernaza, Guayaquil, Ecuador.
authors.forename: Narcisa
authors.initials: N
authors.lastname: Solórzano Zambrano
authors.affiliation: Servicio de Endocrinología, Hospital L. Vernaza, Guayaquil, Ecuador.
authors.forename: Manuel
authors.initials: M
authors.lastname: Navarro Chávez
authors.affiliation: Servicio de Endocrinología, Hospital TMC, Guayaquil, Ecuador.
authors.forename: Camilo
authors.initials: C
authors.lastname: López Estrella
authors.affiliation: Servicio de Neurocirugía, Hospital Docente Policía Nacional N.° 2, Guayaquil, Ecuador.
authors.forename: Luis
authors.initials: L
authors.lastname: Vaca Burbano
authors.affiliation: Servicio de Gastroenterología, Hospital TMC, Guayaquil, Ecuador.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Marriott Díaz
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057210:Delayed Diagnosis; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000453:epidemiology; D006779:Hospitals, Public; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D014505:Urban Population
chemical_list: D019382:Human Growth Hormone
keywords: Acromegalia; Acromegaly; Epidemiology; Epidemiología; Factor de crecimiento insulínico 1; Growth hormone; Hipófisis; Hormona de crecimiento; Insulin-like growth factor 1; Pituitary gland