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The ‘bio-assay’ quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-I concentrations

¹ Departments of Endocrinology, ² Biostatistics and ³ Psychology, Erasmus Medical Centre, University Hospital of Rotterdam, Rotterdam, The Netherlands

(Correspondence should be addressed to Aart Jan van der Lely, Department of Internal Medicine, Erasmus MC, 40 Dr Molewaterplein, 3015 GD Rotterdam, The Netherlands; Email: a.vanderlelij{at}erasmusmc.nl)

Objectives: To investigate the quality of life (QoL) in acromegalic patients in relation to biochemical parameters.

Design and methods: Single-center, open label study in 14 acromegalic patients (eight woman and six men, age 33–77 years), with normal serum IGF-I levels during long-term treatment with monthly injections of 20 mg of long-acting octreotide. We investigated which biochemical parameter might reflect optimal QoL, using the SF-36 questionnaire.

Results: We observed that six patients had a low QoL score at baseline in the same range as observed in cancer patients. The other eight patients had a normal QoL. GH, IGF-I nor free IGF-I could discriminate these two subgroups at baseline. After skipping one monthly injection, all six subjects with the low QoL escaped in their free IGF-I concentrations. Also total IGF-I concentrations escaped in four of these six. In the subjects with normal QoL, free IGF-I levels remained normal in all, while total IGF-I levels only escaped in one.

Conclusions: This study tells us that the currently used biochemical criteria for disease control in acromegaly might be sufficient in assessing long-term mortality and morbidity, but they are insufficient in addressing the most important parameter from the patient’s perspective – QoL.

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				S. M Webb, X. Badia, and Nuria Lara Surinach for the Spanish AcroQoL Study Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur. J. Endocrinol., August 1, 2006; 155(2): 269 - 277. [Abstract] [Full Text] [PDF]