Quality of life after long-term biochemical control of acromegaly.
Quality of life after long-term biochemical control of acromegaly.
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DOI：
10.1007/s11102-022-01224-0
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发表时间：
2022-06
期刊：
影响因子：
3.8
通讯作者：
Miller KK
中科院分区：
文献类型：
--
作者：
Kimball A;Dichtel LE;Yuen KCJ;Woodmansee WW;Haines MS;Nachtigall LB;Swearingen B;Jones P;Tritos NA;Sharpless JL;Kaiser UB;Gerweck A;Miller KK
评估持续生化控制肢端肥大症患者的长期生活质量(QOL)，比较接受和未接受药物治疗的患者(初级分析)；评估随着时间的推移生活质量的变化(二级分析)。对58例生化控制的肢端肥大症患者的横断面研究，包括次级纵向成分。所有患者在接受手术+放射治疗后，都曾在多年前参与过评估生活质量的研究。一组接受了药物治疗[MED(n=33)]；另一组没有[非MED(n=25)]。采用36项简明健康调查问卷(SF-36)、肢端肥大症生活质量问卷(AcroQOL)、胃肠道生活质量指数(GIQLI)、症状问卷和成人生长激素缺乏生活质量评定量表(QOL-AGHDA)评定患者的生活质量。生化控制的平均(±SD)持续时间，MED组为15.0±6.4年，非MED组为20.4±8.2年(P=0.007)。58%的受试者在≥1 SF-36领域得分为正常的25%，32%的受试者在≥4的8个领域得分为正常的25%。比较MED与非MED和对照生化控制的持续时间，SF-36、AcroQOL、GIQLI、症状问卷或QOL-AGHDA的生活质量没有显著差异。生长激素缺乏(GHD)而不是放射治疗预示着较差的生活质量。在MED中，三个AcroQL域和两个GIQLI域的QOL随着时间的推移而改善。在非MED组，生活质量在两个SF-36领域和两个症状问卷领域恶化；在GHD受试者中，QOL-AGHDA得分也恶化。肢端肥大症和GHD的发展史，但不是药物或放射治疗，对QOL是有害的，尽管进行了生化控制，但从长远来看，QOL仍然很差。
To assess long-term quality of life (QoL) in patients with sustained biochemical control of acromegaly, comparing those receiving vs not receiving pharmacotherapy (primary analysis); to assess change in QoL over time (secondary analysis). Cross-sectional study, with a secondary longitudinal component, of 58 patients with biochemically controlled acromegaly. All had participated in studies assessing QoL years previously, after having undergone surgery ± radiotherapy. One cohort received medical therapy [MED (n=33)]; the other did not [NO-MED (n=25)]. QoL was assessed by the 36-Item-Short-Form Health Survey (SF-36), Acromegaly Quality of Life Questionnaire (AcroQoL), Gastrointestinal Quality of Life Index (GIQLI), Symptom Questionnaire, and QoL-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA). Mean (±SD) duration of biochemical control was 15.0 ± 6.4 years for MED and 20.4 ± 8.2 years for NO-MED (p=0.007). 58% of subjects scored <25% of normal on ≥1 SF-36 domain and 32% scored <25% of normal on ≥4 of 8 domains. Comparing MED vs NO-MED and controlling for duration of biochemical control, there were no significant differences in QoL by SF-36, AcroQOL, GIQLI, Symptom Questionnaire, or QoL-AGHDA. Growth hormone deficiency (GHD) but not radiotherapy predicted poorer QoL. In MED, QoL improved over time in three AcroQoL domains and two GIQLI domains. In NO-MED, QoL worsened in two SF-36 domains and two Symptom Questionnaire domains; QoL-AGHDA scores also worsened in subjects with GHD. A history of acromegaly and development of GHD, but not pharmacologic or radiotherapy, are detrimental to QoL, which remains poor over the long-term despite biochemical control.
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