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