title: Morbidity after long-term remission for acromegaly: persisting joint-related complaints cause reduced quality of life.
abstract: Active acromegaly is associated with significant comorbidity and reduced quality of life. However, the prevalence of comorbidity after long-term remission is not established. Therefore, we assessed the presence of comorbidity in 118 patients in long-term remission after surgery, radiotherapy, and/or somatostatin analog treatment according to strict biochemical criteria of serum GH and IGF-I concentrations and evaluated the impact of comorbidity on quality of life. The mean duration of remission was 12.0 +/- 7.4 yr, and mean actual IGF-I sd scores were 0.6 +/- 1.7. Self-reported joint problems occurred in 77% of patients, hypertension in 37%, a history of myocardial infarction in 9%, and diabetes mellitus in 11%. The presence of joint problems was not related to GH and IGF-I levels, active disease duration, or age. Joint complaints had significant negative impact on quality of life. Patients with a history of myocardial infarction had reduced scores for general health, depression, and fatigue, and diabetes mellitus was associated with reduced scores for anxiety and sleep. In conclusion, acromegalic patients had a high prevalence of joint-related comorbidity and hypertension despite long-term control of GH excess. Especially, joint complaints contributed to a reduced perceived quality of life in these patients.
authors.affiliation: Department of Metabolism and Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. nrbiermasz@lumc.nl
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.forename: Jan W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Roelfsema
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000523:psychology; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007592:Joint Diseases / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010003:Osteoarthritis / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life