Matta Maria P, Couture Elisabeth, Cazals Laurent, Vezzosi Delphine, Bennet Antoine, Caron Philippe
Department of Endocrinology and Metabolic Diseases, CHU Larrey, 31059 Toulouse, France.
Eur J Endocrinol. 2008 Mar;158(3):305-10. doi: 10.1530/EJE-07-0697.
Acromegaly, a chronic disease caused by GH/IGF-I excess, has a major impact on quality of life (QoL).
To evaluate QoL of acromegalic patients in relation to control status of the disease.
Single center observational study including 93 patients with acromegaly recruited to complete QoL questionnaire (AcroQol). QoL was evaluated at least 3 months after surgery and/or medical treatment. Patients were divided into two groups: controlled (I) and uncontrolled (II) according to the latest consensus acromegaly 'control' criteria and further subdivided into four subgroups according to the previous pituitary adenoma surgery (Ib and IIb) or without surgery (Ia and IIa).
Mean GH (0.81+/-0.47 ng/ml) and IGF-I (195+/-71 ng/ml) values in group I were significantly lower than in group II (GH, 7.01+/-12.05 ng/ml and IGF-I, 513+/-316 ng/ml; P<0.001). There was no difference in total AcroQol score, physical, or psychological scales between groups I and II. However, when adjusted to age and disease duration since diagnosis, patients of group I (63+/-20%) showed an improved psychological subscale appearance than those of group II (58+/-17%; P=0.035). In group II, IGF-I level was lower after surgery (IIa=588+/-353, IIb=410+/-225 ng/ml; P<0.038), and psychological subscale appearance was significantly better in subgroup IIb (64.9+/-18.1%) than in subgroup IIa who had medical treatment (53.9+/-14.3%; P=0.009).
QoL is severely impaired in acromegalic patients. Control of GH/IGF-I excess by surgery or medical treatment seems to have a positive impact on psychological subscale appearance.
肢端肥大症是一种由生长激素（GH）/胰岛素样生长因子-I（IGF-I）过量引起的慢性疾病，对生活质量（QoL）有重大影响。
评估肢端肥大症患者的生活质量与疾病控制状态的关系。
单中心观察性研究，纳入93例肢端肥大症患者，他们均完成了生活质量问卷（AcroQol）。生活质量在手术和/或药物治疗后至少3个月进行评估。根据最新的肢端肥大症“控制”共识标准，患者被分为两组：病情得到控制组（I组）和未得到控制组（II组），并根据既往垂体腺瘤手术情况（Ib组和IIb组）或未进行手术情况（Ia组和IIa组）进一步细分为四个亚组。
I组的平均GH（0.81±0.47 ng/ml）和IGF-I（195±71 ng/ml）值显著低于II组（GH为7.01±12.05 ng/ml，IGF-I为513±316 ng/ml；P<0.001）。I组和II组在AcroQol总分、身体或心理量表方面没有差异。然而，在根据年龄和自诊断以来的疾病持续时间进行调整后，I组患者（63±20%）在心理亚量表外观方面比II组患者（58±17%）有所改善（P=0.035）。在II组中，手术后IGF-I水平较低（IIa组=588±353，IIb组=410±225 ng/ml；P<0.038），并且IIb亚组（64.9±18.1%）的心理亚量表外观明显优于接受药物治疗的IIa亚组（53.9±14.3%；P=0.009）。
肢端肥大症患者的生活质量严重受损。通过手术或药物治疗控制GH/IGF-I过量似乎对心理亚量表外观有积极影响。
