Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance.
BACKGROUND
Acromegaly, a chronic disease caused by GH/IGF-I excess, has a major impact on quality of life (QoL).


OBJECTIVE
To evaluate QoL of acromegalic patients in relation to control status of the disease.


METHODS
Single center observational study including 93 patients with acromegaly recruited to complete QoL questionnaire (AcroQol). QoL was evaluated at least 3 months after surgery and/or medical treatment. Patients were divided into two groups: controlled (I) and uncontrolled (II) according to the latest consensus acromegaly 'control' criteria and further subdivided into four subgroups according to the previous pituitary adenoma surgery (Ib and IIb) or without surgery (Ia and IIa).


RESULTS
Mean GH (0.81+/-0.47 ng/ml) and IGF-I (195+/-71 ng/ml) values in group I were significantly lower than in group II (GH, 7.01+/-12.05 ng/ml and IGF-I, 513+/-316 ng/ml; P<0.001). There was no difference in total AcroQol score, physical, or psychological scales between groups I and II. However, when adjusted to age and disease duration since diagnosis, patients of group I (63+/-20%) showed an improved psychological subscale appearance than those of group II (58+/-17%; P=0.035). In group II, IGF-I level was lower after surgery (IIa=588+/-353, IIb=410+/-225 ng/ml; P<0.038), and psychological subscale appearance was significantly better in subgroup IIb (64.9+/-18.1%) than in subgroup IIa who had medical treatment (53.9+/-14.3%; P=0.009).


CONCLUSIONS
QoL is severely impaired in acromegalic patients. Control of GH/IGF-I excess by surgery or medical treatment seems to have a positive impact on psychological subscale appearance.
Matta
Maria P
MP
Department of Endocrinology and Metabolic Diseases, CHU Larrey, 31059 Toulouse, France.
Couture
Elisabeth
E
Cazals
Laurent
L
Vezzosi
Delphine
D
Bennet
Antoine
A
Caron
Philippe
P
D000172:Acromegaly / Q000188:drug therapy / Q000378:metabolism* / Q000523:psychology* / Q000601:surgery; D000236:Adenoma / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology / Q000601:surgery; D011184:Postoperative Period; D011788:Quality of Life; D011795:Surveys and Questionnaires
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I