title: Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients.
abstract: OBJECTIVE
  Quality of life is decreased in patients with long-term control of acromegaly. In addition, these patients suffer from irreversible osteoarthritis. The aim of this study was to assess the impact of joint-specific complaints, clinical and radiological signs of arthropathy on different aspects of quality of life (QoL) in patients with acromegaly after long-term disease control.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  We studied 58 patients (31 males), mean age 60 years (range 32-81 years), with strict biochemical control of acromegaly for a mean duration of 15 years. QoL was assessed by four health-related QoL questionnaires (HADS, MFI-20, NHP, SF-36) and one disease specific QoL questionnaire (AcroQoL). The outcomes of these questionnaires were compared with joint-specific self-reported complaints of pain/stiffness, clinical osteoarthritis based on American College of Rheumatology (ACR) and radiological osteoarthritis based on the Kellgren-Lawrence (KL) scoring method.
  
  
  RESULTS
  Long-term cured acromegaly patients had high pain scores of the spine, knee, and hip which limited physical functioning (mean difference -27.0, 95%-CI -9.5, -41.0) and psychological well-being (mean difference -44.4, 95%-CI -26.1, -60.9) (SF-36). Clinical osteoarthritis of the spine was associated mostly with impaired QoL scores, on physical, social, and emotional functioning, and on anxiety and depression. Remarkably, radiological osteoarthritis was not associated with impaired QoL.
  
  
  CONCLUSIONS
  These findings accentuate the importance of recognition of the clinical manifestations of arthropathy in patients with acromegaly despite long-term disease control.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M J E
authors.initials: MJ
authors.lastname: Wassenaar
authors.forename: N R
authors.initials: NR
authors.lastname: Biermasz
authors.forename: M
authors.initials: M
authors.lastname: Kloppenburg
authors.forename: A A
authors.initials: AA
authors.lastname: van der Klaauw
authors.forename: J
authors.initials: J
authors.lastname: Tiemensma
authors.forename: J W A
authors.initials: JW
authors.lastname: Smit
authors.forename: A M
authors.initials: AM
authors.lastname: Pereira
authors.forename: F
authors.initials: F
authors.lastname: Roelfsema
authors.forename: H M
authors.initials: HM
authors.lastname: Kroon
authors.forename: J A
authors.initials: JA
authors.lastname: Romijn
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D000223:Adaptation, Psychological; D001175:Arthrography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010003:Osteoarthritis / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D010146:Pain / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D012107:Research Design