Fujio Shingo, Arimura Hiroshi, Hirano Hirofumi, Habu Mika, Bohara Manoj, Moinuddin F M, Kinoshita Yasuyuki, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan.
Endocr J. 2017 Jan 30;64(1):27-38. doi: 10.1507/endocrj.EJ16-0182. Epub 2016 Sep 29.
Patients with acromegaly have a compromised quality of life (QOL). Modern surgical techniques have improved the surgical cure rate. However, there are no prospective studies reporting postoperative changes in QOL among patients cured solely by surgery. The aim of the present study was to determine the effect of surgery on QOL using the 36-item short form health survey (SF-36) questionnaire. SF-36 scores comprise 3 components: the physical component summary (PCS), the mental component summary (MCS) and role-social component summary (RCS). Included in this prospective cohort were 41 patients with acromegaly who underwent surgery alone and achieved postoperative normalization of insulin-like growth factor-1. All participants completed the SF-36 preoperatively and 1 year postoperatively. Preoperatively, RCS and 4 subscale scores (role physical, social functioning, role emotional, mental health) were below the set standards for the normal population. Postoperatively, the PCS and RCS scores did not change significantly, but the MCS score improved significantly (from 48.1 ± 11.3 to 51.7 ± 8.9, p=0.03). Further we compared the QOL of 26 patients whose nadir GH level was < 0.4 μg/L during postoperative oral glucose tolerance testing (complete remission group) with that of 15 patients whose nadir GH level was ≥ 0.4 μg/L (partial remission group). There were no significant differences between these groups in terms of PCS, MCS, RCS, or any subscale scores. In conclusion, surgical remission mostly improved the participants' mental condition. There was no difference in QOL between patients who achieved the new remission criteria and those who did not.
肢端肥大症患者的生活质量(QOL)受损。现代手术技术提高了手术治愈率。然而,尚无前瞻性研究报告仅通过手术治愈的患者术后生活质量的变化。本研究的目的是使用36项简短健康调查(SF-36)问卷来确定手术对生活质量的影响。SF-36评分包括3个组成部分:身体成分总结(PCS)、心理成分总结(MCS)和角色-社会成分总结(RCS)。该前瞻性队列纳入了41例仅接受手术治疗且术后胰岛素样生长因子-1恢复正常的肢端肥大症患者。所有参与者在术前和术后1年完成了SF-36问卷。术前,RCS和4个分量表评分(角色身体、社会功能、角色情绪、心理健康)低于正常人群的设定标准。术后,PCS和RCS评分无显著变化,但MCS评分显著改善(从48.1±11.3提高到51.7±8.9,p=0.03)。此外,我们比较了26例术后口服葡萄糖耐量试验中最低生长激素水平<0.4μg/L的患者(完全缓解组)与15例最低生长激素水平≥0.4μg/L的患者(部分缓解组)的生活质量。这些组在PCS、MCS、RCS或任何分量表评分方面无显著差异。总之,手术缓解大多改善了参与者的心理状况。达到新缓解标准的患者与未达到该标准的患者在生活质量方面没有差异。