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Decreased quality of life in patients with acromegaly

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J Clin Endocrinol Metab Biermasz et al. 89 (11): 5369. (204K)


Nienke R. Biermasz, Sjoerd W. van Thiel, Alberto M. Pereira, Hendrieke C. Hoftijzer, Albert M. van Hemert, Jan W. A. Smit, Johannes A. Romijn and Ferdinand Roelfsema Department of Endocrinology, Leiden University Medical Center (N.R.B., S.W.v.T., A.M.P., H.C.H., J.W.A.S., J.A.R., F.R.), 2333 ZA Leiden, The Netherlands; and Parnassia Psychomedical Center (A.M.v.H.), 2553 RJ The Hague, The Netherlands Address all correspondence and requests for reprints to: Dr. N. R. Biermasz, Department of Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. E-mail: Dit e-mailadres wordt beveiligd tegen spambots. JavaScript dient ingeschakeld te zijn om het te bekijken. Dit e-mailadres is beschermd tegen spambots. U heeft JavaScript nodig om het te kunnen zien. .
AbstractThe long-term impact of acromegaly on subjective well-beingafter treatment of GH excess is unclear. Therefore, we evaluatedquality of life by validated questionnaires in a cross-sectionalstudy of 118 successfully treated acromegalic patients. Theinitial treatment was transsphenoidal surgery in most patients(92%), if necessary followed by radiotherapy or octreotide.All patients were in remission at the time of assessment (GH,<1.9 µg/liter; normal IGF-I for age). General perceivedwell-being was reduced compared with controls for all subscales(P < 0.001) as measured by the Nottingham Health Profileand the Short Form-36. Acromegalic patients also had lower scoreson fatigue (Multidimensional Fatigue Index) and anxiety anddepression (Hospital Anxiety and Depression Scale). Radiotherapywas associated with decreased quality of life in all subscalesexcept for the Hospital Anxiety and Depression Scale, and worsenedquality of life significantly, according to the fatigue scores.Somatostatin analog treatment was not associated with improvedquality of life. Independent predictors of quality of life wereage (physical subscales and Nottingham Health Profile), diseaseduration (social isolation and personal relations), and radiotherapy(physical and fatigue subscales). In conclusion, patients curedafter treatment for acromegaly have a persistently decreasedquality of life despite long-term biochemical cure of GH excess.Radiotherapy especially is associated with a reduced qualityof life.