The 'bio-assay' quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-I concentrations.
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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.
- Middle aged
- Biological Markers
- Insulin-Like Growth Factor Binding Protein 3/blood
- *Quality of Life
- *Severity of Illness Index
- Insulin-Like Growth Factor I/*metabolism
- Human Growth Hormone/blood
- Acromegaly/*diagnosis/drug therapy/*psychology
- Antineoplastic Agents, Hormonal/administration & dosage/adverse effects
- Octreotide/administration & dosage/adverse effects