Quality of life after long-term biochemical control of acromegaly.

Autor: Kimball A; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA. akimball1@partners.org.; Harvard Medical School, Boston, MA, USA. akimball1@partners.org., Dichtel LE; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA., Yuen KCJ; Swedish Pituitary Center, Swedish Neuroscience Institute, Seattle, WA, USA.; Barrow Pituitary Center, Barrow Neurological Institute, University of Arizona School of Medicine and Creighton School of Medicine, Phoenix, AZ, USA., Woodmansee WW; Harvard Medical School, Boston, MA, USA.; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA.; Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA., Haines MS; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA., Nachtigall LB; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA., Swearingen B; Harvard Medical School, Boston, MA, USA.; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA., Jones P; Harvard Medical School, Boston, MA, USA.; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA., Tritos NA; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA., Sharpless JL; Department of Endocrinology, University of North Carolina, Chapel Hill, NC, USA.; National Institutes of Health, Bethesda, MD, USA., Kaiser UB; Harvard Medical School, Boston, MA, USA.; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA., Gerweck A; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA., Miller KK; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 457, Boston, MA, 02114, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Pituitary [Pituitary] 2022 Jun; Vol. 25 (3), pp. 531-539. Date of Electronic Publication: 2022 Apr 27.
DOI: 10.1007/s11102-022-01224-0
Abstrakt: Purpose: To assess long-term quality of life (QoL) in patients with sustained biochemical control of acromegaly, comparing those receiving vs not receiving pharmacotherapy (primary analysis); to assess change in QoL over time (secondary analysis).
Methods: Cross-sectional study, with a secondary longitudinal component, of 58 patients with biochemically controlled acromegaly. All had participated in studies assessing QoL years previously, after having undergone surgery ± radiotherapy. One cohort received medical therapy [MED (n = 33)]; the other did not [NO-MED (n = 25)]. QoL was assessed by the 36-Item-Short-Form Health Survey (SF-36), Acromegaly Quality of Life Questionnaire (AcroQoL), Gastrointestinal Quality of Life Index (GIQLI), Symptom Questionnaire, and QoL-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA).
Results: Mean (± SD) duration of biochemical control was 15.0 ± 6.4 years for MED and 20.4 ± 8.2 years for NO-MED (p = 0.007). 58% of subjects scored < 25% of normal on ≥ 1 SF-36 domain and 32% scored < 25% of normal on ≥ 4 of 8 domains. Comparing MED vs NO-MED and controlling for duration of biochemical control, there were no significant differences in QoL by SF-36, AcroQOL, GIQLI, Symptom Questionnaire, or QoL-AGHDA. Growth hormone deficiency (GHD) but not radiotherapy predicted poorer QoL. In MED, QoL improved over time in three AcroQoL domains and two GIQLI domains. In NO-MED, QoL worsened in two SF-36 domains and two Symptom Questionnaire domains; QoL-AGHDA scores also worsened in subjects with GHD.
Conclusion: A history of acromegaly and development of GHD, but not pharmacologic or radiotherapy, are detrimental to QoL, which remains poor over the long-term despite biochemical control.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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