SFEBES2023 Oral Poster Presentations Neuroendocrinology and Pituitary (4 abstracts)
Biochemical control does not improve functional impairment in people with acromegaly
Nawaz Z Safdar 1 , Megan Heague 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 Murray 2
1School of Medicine, University of Leeds, Leeds, United Kingdom. 2Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, St James’ University Hospital, 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
Acromegaly, a chronic disorder of excessive growth hormone secretion, leads to functional limitation and impaired mobility most commonly due to arthropathy. Patients with biochemically controlled acromegaly have reported persistent impairment in prior studies. We aimed to compare the functional differences in patients with biochemically controlled acromegaly to those with uncontrolled disease by means of validated questionnaires. Between March 2017 and May 2022, patients over 18 years old, diagnosed with acromegaly were recruited to fill out validated questionnaires at a tertiary hospital in this cross-sectional study. Exclusion criteria were co-morbid inflammatory arthritis, recent musculoskeletal trauma (<3 months), active cancer, and impaired cognition. Data on the activities of daily living (ADL) and sport function subsections of the Knee injury and Osteoarthritis Outcome Score (KOOS), and the Health Assessment Questionnaire (HAQ) were collected. Patient demographics and biochemical data were also collected. Biochemical control of acromegaly was defined as a growth hormone (GH) level of <1.0 mg/l alongside an insulin-like growth factor-1 (IGF-1) within range at the time of data collection. Data are presented as medians and interquartile ranges (IQR). Of the 85 patients (median age 58 years (IQR 52, 68), 52.9% females, GH 0.6 mg/l [0.2, 1.5], and IGF-1 24.9 nmol/l [17.2, 36.8]), seven patients had missing biochemical data, resulting in 39 patients (50%) with control and 39 without. There was functional impairment (KOOS-ADL controlled 89.7% vs. uncontrolled 86.8%, P=0.63; KOOS-sport function 65% vs. 70%, P=0.84; and HAQ 0.25 vs. 0.25, P=0.41) across both groups; the impairment was equally severe in those with and without control. Age, gender, GH, and/or IGF-1 did not predict impairment in our cohort. Despite adequate biochemical control of acromegaly, patients reported ongoing functional impairment across multiple domains of activity. Longitudinal data on biochemical burden are needed to draw further conclusions.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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