About the PhD thesis

Acromegaly is a rare disease caused by a growth hormonesecreting pituitary adenoma, leading to elevated circulating levels of growth hormone and IGF-I with systemic conse-quences. Using Danish national registries, this thesis demonstrates a higher incidence and prevalence of acromegaly than previously reported, along with a shift in disease presentation toward a less aggressive phenotype in older individuals.

Several well-known comorbidities and socioeconomic challenges are detectable years before diagnosis, highlighting the importance of increased awareness and earlier detection. The thesis further demonstrates that the overall cancer risk in acromegaly is lower than previously assumed, possibly due to diagnostic work-up bias, whereas the risk of joint disease remains increased despite adequate disease control. Significant sex differences are identified in clinical presen-tation, comorbidity burden, quality of life, and socioeconomic status.

Genetic analyses elucidate the role of known and novel variants associated with familial and early-onset acromegaly. Finally, the assessment of disease activity during medical treatment is examined, demonstrating both limitations and strengths of growth hormone and IGF-I as biomarkers.