Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess.
The long-term impact of acromegaly on subjective well-being after treatment of GH excess is unclear. Therefore, we evaluated quality of life by validated questionnaires in a cross-sectional study of 118 successfully treated acromegalic patients. The initial treatment was transsphenoidal surgery in most patients (92%), if necessary followed by radiotherapy or octreotide. All patients were in remission at the time of assessment (GH, <1.9 mug/liter; normal IGF-I for age). General perceived well-being was reduced compared with controls for all subscales (P < 0.001) as measured by the Nottingham Health Profile and the Short Form-36. Acromegalic patients also had lower scores on fatigue (Multidimensional Fatigue Index) and anxiety and depression (Hospital Anxiety and Depression Scale). Radiotherapy was associated with decreased quality of life in all subscales except for the Hospital Anxiety and Depression Scale, and worsened quality of life significantly, according to the fatigue scores. Somatostatin analog treatment was not associated with improved quality of life. Independent predictors of quality of life were age (physical subscales and Nottingham Health Profile), disease duration (social isolation and personal relations), and radiotherapy (physical and fatigue subscales). In conclusion, patients cured after treatment for acromegaly have a persistently decreased quality of life despite long-term biochemical cure of GH excess. Radiotherapy especially is associated with a reduced quality of life.
Biermasz
Nienke R
NR
Department of Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. nrbiermasz@lumc.nl.
van Thiel
Sjoerd W
SW
Pereira
Alberto M
AM
Hoftijzer
Hendrieke C
HC
van Hemert
Albert M
AM
Smit
Jan W A
JW
Romijn
Johannes A
JA
Roelfsema
Ferdinand
F
D000172:Acromegaly / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires
D019382:Human Growth Hormone