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J Clin Endocrinol Metab Biermasz et al. 90 (5): 2731. (159K)
Morbidity after Long-Term Remission for Acromegaly: Persisting Joint-Related Complaints Cause Reduced Quality of Life
Nienke R. Biermasz, Alberto M. Pereira, Jan W. A. Smit, Johannes A. Romijn and Ferdinand Roelfsema
Department of Metabolism and Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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.