Treatment of acromegaly improves quality of life, measured by AcroQol
Treatment of acromegaly improves quality of life, measured by AcroQol
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DOI：
10.1111/j.1365-2265.2007.02891.x
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发表时间：
2007-09-01
影响因子：
3.2
通讯作者：
Trainer, Peter J.
中科院分区：
文献类型：
--
作者：
Paisley, Angela N.;Rowles, Susannah V.;Trainer, Peter J.
AcroQol是一份由疾病产生的问卷，用于评估肢端肥大症患者的生活质量。我们之前已经证明肢端肥大症患者的生活质量严重受损，并且在横断面研究中，与非疾病特异性通用工具“心理一般健康量表”（PGWBS）和EuroQol （EQ-5D）以及疾病特异性体征和症状评分（SSS）相比，AcroQol在测量生活质量方面的价值。我们在对56例先前报道的患者（33例男性，平均年龄55±15岁）的纵向研究中重新评估了这些工具，以确定生活质量随时间的变化和不同治疗方式的效果。数据分析采用Spearman相关检验。基线IGF-I中位数为354ng /ml（范围48-899），重新评估时为217 ng/ml (60-594) (P < 0.001)[中位时间间隔608天（113-1136）]。分析IGF-I水平的变化和AcroQol评分显示出显著的负相关(即IGF-I的降低与总体生活质量的改善相关（r = -0.36, P = 0.006）。生理（r = -0.33, P = 0.01）、心理（r = -0.37, P = 0.005）和外貌（r = -0.42, P = 0.001）的AcroQol子域也存在显著负相关。IGF-I的变化与PGWBS总体评分或子域、SSS或EQ-5D的变化之间没有相关性。总之，在研究的工具中，我们已经证明了AcroQol是唯一能够检测与治疗诱导的肢端肥大症患者疾病活动的主要生化标志物改善相关的生活质量变化的工具。需要进一步的研究来评估AcroQol中所见变化的长期生物学意义。
AcroQol is a disease-generated questionnaire, developed to assess quality of life (QOL) in patients with acromegaly. We have previously demonstrated severely impaired QOL in patients with acromegaly and the value of AcroQol in measuring QOL in a cross-sectional study compared with the non-disease-specific generic tools 'Psychological general wellbeing schedule' (PGWBS) and EuroQol (EQ-5D), and the disease-specific signs and symptoms score (SSS).We re-evaluated these tools in a longitudinal study of 56 of the previously reported patients (33 male, mean age 55 +/- 15 years), in order to determine change in QOL over time and the effect of different treatment modalities. Data were analysed using Spearman's correlation tests.Baseline median IGF-I was 354 ng/ml (range 48-899) and at re-evaluation 217 ng/ml (60-594) (P < 0.001) [median time interval 608 days (113-1136)]. Analysis of change in IGF-I levels and AcroQol scores demonstrated a significant negative correlation (i.e. a reduction in IGF-I being associated with improved overall QOL (r = -0.36, P = 0.006). Significant negative correlations were also seen in the physical (r = -0.33, P = 0.01), psychological (r = -0.37, P = 0.005) and appearance (r = -0.42, P = 0.001) AcroQol subdomains. No correlations were seen between change in IGF-I and change in overall PGWBS score or subdomains, SSS or EQ-5D.In summary, of the tools studied we have demonstrated AcroQol to be uniquely capable of detecting changes in QOL associated with treatment-induced improvement in the main biochemical marker of disease activity in patients with acromegaly. Further studies are required to evaluate the long-term biological significance of the changes seen in AcroQol.