Quality of life after multimodality treatment of acromegaly

Abstract

AIM: To assess the impact of acromegaly on quality of life (QoL) as evaluated by the acromegaly QoL (AcroQoL) questionnaire in Maltese patients with cured, controlled and uncontrolled acromegaly.

DESIGN: Cross-sectional survey study.

METHODS: The AcroQol questionnaire was completed by all patients during their routine outpatient visit. Clinical and hormonal data including GH and IGF1 levels were also taken at the time of survey.

RESULTS: Forty-seven patients were included in the study, (22 males, 25 females). The median GH was 0.78 μg/l (IQR 0.4–1.6), the median insulin-like growth factor 1 (IGF1) was 192 μg/l (IQR 139–306) while the mean IGF1 z-score was 1.05 (SD 1.15) The mean AcroQol total score for the whole group was 67.3 (SD 16.89). The score for the physical dimension was 66.5 (SD 23.41), and the score for the psychological dimension was 67.8 (SD 16.14). The subscale appearance was the worse affected, scoring 57.3 (SD 21.60), while for personal relations the score was 78.3 (SD 16.03). Females had significantly lower total scores, (P<0.02) and physical scores (P<0.001). No correlation was found between AcroQol scores and age at diagnosis, size of tumour, previous treatment with radiotherapy and surgery, hypopituitarism, presence of co-morbidities and GH and IGF1 levels.

CONCLUSIONS: This study shows that patients with acromegaly exhibit marked impairment of QoL especially from the appearance point of view. Overall females when compared to males have a worse QoL particularly in relation to the physical aspect. No correlation was found between AcroQol and serum GH and IGF1 levels at time of administration of the questionnaire.