The 'bio-assay' quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-I concentrations.
OBJECTIVE
To investigate the quality of life (QoL) in acromegalic patients in relation to biochemical parameters.


METHODS
Single-center, open label study in 14 acromegalic patients (eight woman and six men, age 33-77 years), with normal serum IGF-I levels during long-term treatment with monthly injections of 20 mg of long-acting octreotide. We investigated which biochemical parameter might reflect optimal QoL, using the SF-36 questionnaire.


RESULTS
We observed that six patients had a low QoL score at baseline in the same range as observed in cancer patients. The other eight patients had a normal QoL. GH, IGF-I nor free IGF-I could discriminate these two subgroups at baseline. After skipping one monthly injection, all six subjects with the low QoL escaped in their free IGF-I concentrations. Also total IGF-I concentrations escaped in four of these six. In the subjects with normal QoL, free IGF-I levels remained normal in all, while total IGF-I levels only escaped in one.


CONCLUSIONS
This study tells us that the currently used biochemical criteria for disease control in acromegaly might be sufficient in assessing long-term mortality and morbidity, but they are insufficient in addressing the most important parameter from the patient's perspective--QoL.
Bonapart
Ingrid E
IE
Department of Endocrinology, Erasmus Medical Centre, University Hospital of Rotterdam, Rotterdam, The Netherlands.
van Domburg
Ron
R
ten Have
Saskia M T H
SM
de Herder
Wouter W
WW
Erdman
Ruud A M
RA
Janssen
Joop A M J L
JA
van der Lely
Aart Jan
AJ
D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects; D015415:Biomarkers; D005260:Female; D006240:Happiness; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide