Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance
Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance
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DOI：
10.1530/eje-07-0697
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发表时间：
2008-03-01
影响因子：
5.8
通讯作者：
Caron, Philippe
中科院分区：
文献类型：
--
作者：
Matta, Maria P.;Couture, Elisabeth;Caron, Philippe
肢端肥大症是一种由GH/IGF-I过量引起的慢性疾病，对生活质量（QoL）有重大影响。目的：评价肢端肥大症患者生活质量与疾病控制状况的关系。设计与方法：选取93例肢端肥大症患者进行单中心观察性研究，填写生活质量问卷（AcroQol）。在手术和/或药物治疗后至少3个月评估生活质量。根据最新一致的肢端肥大症“控制”标准将患者分为对照(1)和非对照（11）两组，并根据既往垂体腺瘤手术（Ib和IIb）或未手术（Ia和IIa）进一步细分为4个亚组。结果：ⅰ组平均GH值（0.81 +/- 0.47 ng/ml）和IGF-I值（195 +/- 71 ng/ml）显著低于ⅱ组（GH值7.01 +/- 12.05 ng/ml和IGF-I值513 +/- 316 ng/ml， P < 0.001）。第一组和第二组的AcroQol总分、生理和心理量表均无差异。然而，当调整到年龄和自诊断以来的疾病持续时间时，I组患者（63 20%）的心理亚量表外观比II组（58 +/- 17%，P=0.035）有所改善。II组术后IGF-I水平较低（IIa=588 +/- 353, IIb=410 +/- 225ng/ml, P < 0.038）， IIb亚组心理亚量表外观（64.9 +/- 18.1%）明显优于内科治疗的IIa亚组（53.9 +/- 14.3 %，P=0.009）。结论：肢端肥大症患者OoL功能严重受损。通过手术或药物治疗控制GH/ igf - 1过量似乎对心理亚量表外观有积极影响。
Introduction: Acromegaly, a chronic disease caused by GH/IGF-I excess, has a major impact on quality of life (QoL).Objective: To evaluate QoL of acromegalic patients in relation to control status of the disease.Design and rnethods: 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 (1) and uncontrolled (11) 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).Results: 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 +/- 225ng/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).Conclusion: OoL 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.