SFEBES2023 Oral Communications Neuroendocrinology and Pituitary (6 abstracts)
The effects of biochemical control and Arthropathy on Quality of Life in patients with Acromegaly: a cross-sectional study
Megan Heague 1 , Nawaz Safdar 1 , Sophie Hebden 1 , Julie Lynch 2 , David McLaren 2 , Alberto Tresoldi 3 , Kirstie Lithgow 3 , Sandrine Urwyler 3 , Shahzad Akbar 4 , Katie McLoughlin 5 , Tara Kearney 5 , William M. Drake 6 , Thozhukat Sathyapalan 4 , Steve Orme 2 , Claire E. Higham 7 , Niki Karavitaki 3 , Nikolaos Kyriakakis 2 & Robert D. Murray 2
1School of Medicine, University of Leeds, Leeds, United Kingdom. 2Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. 3Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom. 4Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, United Kingdom. 5Department of Endocrinology, Salford Royal Foundation Trust, Manchester, United Kingdom. 6Centre for Endocrinology, Barts and The London School of Medicine, Queen Mary University of London, London, United Kingdom. 7Department of Endocrinology, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
One of the most prevalent clinical manifestations of acromegaly is arthropathy which persists despite adequate symptom and biochemical control, and contributes to impaired quality of life. Patients with acromegaly have high psychiatry morbidity and increased prevalence of depression and poor psychological wellbeing. In a large cohort we aim to determine the effects of joint disease and disease control on quality of life in acromegaly. Eighty-five patients (45 women; median age 58) with acromegaly were enrolled in our study. Seven patients were excluded due to missing data. Joint pain was assessed using a Joint Pain ‘Human Figure’ and AcroQoL, EQ-5D, Hospital Anxiety and Depression Scale (HADS) questionnaires were completed by all patients. Demographic information and biochemical data were also obtained from electronic health records. Biochemical control was defined as growth hormone <1.0 mg/l and IGF-1 within the patient specific range at the time of data collection. Data are represented as medians and P<0.05 was considered statistically significant. Patients with uncontrolled acromegaly displayed worse QoL scores than controlled patients (AcroQoL 65.35 vs 70, p>0.05; EQ-5D 0.72 vs 0.74, p>0.05), although the difference was not statistically significant. HADS showed very high rates of anxiety and depression, 37.2% and 27.1% respectively, but no significant differences were found between the controlled vs uncontrolled group. Greater number of joints affected was significantly associated with impaired average AcroQol (r2=0.011, P<0.0001) and impaired EQ-5D quality of life scores (r2=0.0002, P<0.0001). GH and IGF-1 levels were not found to significantly correlate with number of joints affected (r2=0.0156, 0.0141; p>0.05). Quality of life and arthropathy are independent of biochemical disease control suggesting other interventions may be required to improve symptoms. Arthropathy was a significant predictor of impaired quality of life and poor psychological wellbeing highlighting that monitoring of joint disease is crucial to improve quality of life outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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