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3% (CI95% 51.5-55.2) with considerable heterogeneity (I =85%) among the studies. The mean age difference at diagnosis between genders was 3.1years (CI95% 1.9-4.4), and the diagnostic delay was longer in females by 0.9years (CI95% -0.4 to 2.1). Serum IGF-I levels were significantly lower in female patients, whereas nadir GH, and pituitary adenoma size were comparable. There are only a minor sex differences in the epidemiology of acromegaly at the time of diagnosis except that female patients are slightly older and exhibit lower IGF-I c