The Risk of Neurodegenerative Diseases in Patients With Acromegaly: A Cohort Study

Abstract

Background and Objectives:A few recent studies have reported an association between insulin-like growth factor-1 (IGF-1) and neurodegenerative disease, but there was no report on any association between acromegaly and neurodegenerative disease. We investigated whether the risk of Alzheimer's disease, Parkinson's disease and other neurodegenerative diseases were increased among patients with acromegaly using nationwide data of Korea.Methods:We studied the association between acromegaly and Parkinson’s disease and dementia in 1,611 patients with acromegaly and controls (age- and sex-matched 8055 participants with no diagnosis of acromegaly) from the National Health Insurance System database between 2006 and 2016 with a mean follow-up period of 7.34 years. Cox proportional hazards regression analysis was used to assess the risk of all outcomes in patients with acromegaly compared with controls with adjusting for age, sex, household income, place, type 2 diabetes, hypertension, and dyslipidaemia.Results:The average age of the acromegaly patients and the controls was 54.16 years old (40.4% men). The incidence rate of Parkinson’s disease in patients with acromegaly (1.54 per 1,000 person-years) was significantly higher than that in the control group (0.55 per 1,000 person-years) (log-rank test p=0.001). Acromegaly was associated with a higher risk of Parkinson’s disease (hazard ratio [HR]= 2.609, 95% confidence interval [CI]: 1.410 to 2.609) than the control. In addition, acromegaly was associated with a higher risk of all-cause dementia (HR=2.299, 95% CI: 1.362–3.881), Alzheimer`s disease (HR=2.228, 95% CI: 1.191–4.168) and Non-AD dementia (HR=6.553, 95% CI: 1.754–24.482) than the control during the first three years after diagnosis and treatment. In subgroup analysis, diabetes was associated with higher risk of all-cause dementia (P for interaction=0.028) in patients with acromegaly compared with controls.Discussion:Our study results suggest that acromegaly is associated with neurodegenerative disease. Further study is needed on the association between IGF-1/growth hormone level and neurodegenerative disease.