Endocrine Abstracts (2004) 7 P126

Improved quality of life (QOL) with normalisation of IGF-I in patients with acromegaly

AN Paisley, SV Rowles, ME Roberts, C Lee & PJ Trainer


Department of Endocrinology, Christie Hospital, Manchester, UK.


We have previously reported comparisons of ACROQOL, a disease-specific questionnaire for QOL in patients with acromegaly, with the non-disease-specific generic tools Psychological General Well-Being Schedule (PGWBS) and EUROQOL and disease-specific signs and symptoms score (SSS). ACROQOL comprises 22 questions (subdivided into physical and psychological classes, total score out of 110 quoted as percentage, higher scores = better QOL). SSS rates 5 features of acromegaly each rated on a scale of 0 to 8 (total score out of 40, higher score = worse QOL). PGWBS consists of 22 questions in 6 subsets, total score out of 110 (higher score = better QOL, normal around 80). We report the re-evaluation with the same tools of 19 patients (11 female, mean age 53) with an initially elevated IGF-I that has subsequently normalised. Ethical approval was obtained. Data were analysed using Wilcoxon matched pairs test and Spearmans rank correlations. With treatment IGF-I fell from a median of 391.42 ng/ml (range 243-898) to 218 ng/ml (69-292) over a median of 478 days (range 100-749). Total ACROQOL score increased significantly from a median of 48.9% (range 26.1-86.4%) to 54.6% (range 29.5-90.9%) (P=0.02) with marked improvements in the psychological (P=0.015) and appearance (P=0.003) sub-sections. Concomitant significant increases occurred in total PGWBS score, from a median of 69/110 (39-98) to 77/110 (51-106) (P=0.01), with significant improvement in the domains for anxiety (P=0.002) and vitality (P=0.03). A significant improvement was noted on the Euroqol visual analog scale from 65/100 (30-90) to 70/100 (45-97) (P=0.03), however no improvement was seen in SSS (baseline median 14/40 (4-26), follow-up 12/40 (2-26) (P=0.67). No correlations were found between the questionnaires. In summary, normalisation of IGF-I results in an improvement, but does not normalise QOL in patients with acromegaly. This is the first study to document an improvement in ACROQOL with normalisation of IGF-I.

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