Disease control and treatment modalities have impact on quality of life in acromegaly evaluated by Acromegaly Quality of
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ORIGINAL ARTICLE
Disease control and treatment modalities have impact on quality of life in acromegaly evaluated by Acromegaly Quality of Life (AcroQoL) Questionnaire Silvia Vandeva • Maria Yaneva • Emil Natchev Atanaska Elenkova • Krasimir Kalinov • Sabina Zacharieva
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Received: 16 August 2014 / Accepted: 21 December 2014 Ó Springer Science+Business Media New York 2014
Abstract Various factors influence quality of life (QoL) in acromegaly. Whether disease control and treatment approach are related to QoL is still a matter of debate. The aim of the present study was to evaluate QoL in patients with acromegaly using the disease-specific Acromegaly Quality of Life Questionnaire in respect to disease activity, treatment modalities, and other factors. We studied 212 patients with acromegaly in a cross-sectional manner over a 6-year period in a single tertiary center. As a second step, seventy of the patients who were with active disease at baseline were followed up prospectively and 45 of them were in remission at re-evaluation. In regard to the crosssectional group, active acromegaly independently predicted worse appearance scores. Prior radiotherapy and older age were independent negative predictors of all scales. Female gender negatively predicted all scales except the appearance domain. Longer duration of remission predicted worse personal relations scores in biochemically controlled patients. The use of somatostatin analog (SSA) was associated with worse personal relations scores, while higher IGF-1 index predicted worse appearance scores in patients with active acromegaly. In the prospective group, achievement of remission independently predicted improvement of the total scale. Lower corresponding baseline scores predicted improvement of the total, physical, and appearance scales, while the absence of hypopituitarism independently predicted improvement of the S. Vandeva (&) M. Yaneva E. Natchev A. Elenkova S. Zacharieva Clinical Center of Endocrinology and Gerontology, Medical University – Sofia, Zdrave 2 str., 1431 Sofia, Bulgaria e-mail: [email protected] K. Kalinov New Bulgarian University, Sofia, Bulgaria
appearance scale. The use of SSA was associated with improvement of the total and appearance scores. In conclusion, QoL is a multifactorial issue that needs an individualized approach for detection and management. Keywords Acromegaly Quality of life IGF-1 Somatostatin analogs Radiotherapy
Introduction Acromegaly is a rare chronic disorder caused by pituitary adenoma in almost all cases. It manifests with facial and acral deformity and multiple systemic complications that lead to increased cardiovascular, respiratory, and neoplastic mortalities [1]. Apart from the physical changes, patients with acromegaly show some psychosocial alterations resulting altogether in decreased self-perception of well-being [2]. Achievement of disease control is expected to restore life expectancy to levels similar to the general population [1]. However, it is still debatable whether normalization of GH and
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