Skip to main content

Advertisement

SpringerLink
Log in

The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL

  • Published:
Pituitary Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Purpose

To develop a Japanese version of the acromegaly quality of life (QoL) questionnaire (AcroQoL) and investigate the factors associated with impaired QoL in patients with acromegaly.

Methods

We developed a Japanese version of the AcroQoL by a forward–backward method and evaluated QoL in 38 patients with acromegaly who had been followed up at an outpatient clinic at Kobe University Hospital. Its reliability was examined with Cronbach’s alpha and item–total correlations. Second examination was performed for concurrent validity by assessment of correlations with the Short Form-36 (SF-36) and longitudinal analysis of the AcroQoL in 25 patients.

Results

Cronbach’s alpha and item–total correlations showed a range of 0.76–0.93 and 0.20–0.84, respectively, and significant correlations were found between the AcroQoL and the SF-36. Younger age and a history of radiotherapy were associated with worse total score by the multivariate linear regression analysis (p = 0.020 and p = 0.042, respectively). Intriguingly, in the biochemically-controlled group after the exclusion of patients who received radiotherapy, patients who underwent surgery alone exhibited a higher psychological (75.0 vs. 65.7 %, p = 0.036) and appearance (64.3 vs. 53.6 %, p = 0.036) score than those who are treating with pharmaceutical therapy.

Conclusions

The reliability of the Japanese version of the AcroQoL was satisfactory. Younger age and a history of radiotherapy were associated with lower QoL in patients with acromegaly. In biochemically-controlled acromegaly, patients who underwent surgery alone exhibited better QoL than those under pharmaceutical therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Biermasz NR, Pereira AM, Smit JW et al (2005) Morbidity after long-term remission for acromegaly: persisting joint-related complaints cause reduced quality of life. J Clin Endocrinol Metab 90:2731–2739

    Article  CAS  PubMed  Google Scholar 

  2. Biermasz NR, van Thiel SW, Pereira AM et al (2004) Decreased quality of life in patients with acromegaly despite long-term cure of growth hormone excess. J Clin Endocrinol Metab 89:5369–5376

    Article  CAS  PubMed  Google Scholar 

  3. Roerink SH, Wagenmakers MA, Wessels JF et al (2015) Persistent self-consciousness about facial appearance, measured with the Derriford appearance scale 59, in patients after long-term biochemical remission of acromegaly. Pituitary 18:366–375

    Article  CAS  PubMed  Google Scholar 

  4. Melmed S, Colao A, Barkan A et al (2009) Guidelines for acromegaly management: an update. J Clin Endocrinol Metab 94:1509–1517

    Article  CAS  PubMed  Google Scholar 

  5. Schofl C, Franz H, Grussendorf M et al (2013) Long-term outcome in patients with acromegaly: analysis of 1344 patients from the German Acromegaly Register. Eur J Endocrinol 168:39–47

    Article  PubMed  Google Scholar 

  6. Holdaway IM, Bolland MJ, Gamble GD (2008) A meta-analysis of the effect of lowering serum levels of GH and IGF-I on mortality in acromegaly. Eur J Endocrinol 159:89–95

    Article  CAS  PubMed  Google Scholar 

  7. Webb SM, Badia X, Surinach NL (2006) Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol 155:269–277

    Article  CAS  PubMed  Google Scholar 

  8. Trepp R, Everts R, Stettler C et al (2005) Assessment of quality of life in patients with uncontrolled vs. controlled acromegaly using the Acromegaly Quality of Life Questionnaire (AcroQoL). Clin Endocrinol (Oxf) 63:103–110

    Article  Google Scholar 

  9. Paisley AN, Rowles SV, Roberts ME et al (2007) Treatment of acromegaly improves quality of life, measured by AcroQol. Clin Endocrinol (Oxf) 67:358–362

    Article  CAS  Google Scholar 

  10. Hua SC, Yan YH, Chang TC (2006) Associations of remission status and lanreotide treatment with quality of life in patients with treated acromegaly. Eur J Endocrinol 155:831–837

    Article  CAS  PubMed  Google Scholar 

  11. Neggers SJ, van Aken MO, de Herder WW et al (2008) Quality of life in acromegalic patients during long-term somatostatin analog treatment with and without pegvisomant. J Clin Endocrinol Metab 93:3853–3859

    Article  CAS  PubMed  Google Scholar 

  12. Crespo I, Valassi E, Santos A et al (2015) Health-related quality of life in pituitary diseases. Endocrinol Metab Clin N Am 44:161–170

    Article  Google Scholar 

  13. Rowles SV, Prieto L, Badia X et al (2005) Quality of life (QOL) in patients with acromegaly is severely impaired: use of a novel measure of QOL: acromegaly quality of life questionnaire. J Clin Endocrinol Metab 90:3337–3341

    Article  CAS  PubMed  Google Scholar 

  14. van der Klaauw AA, Biermasz NR, Hoftijzer HC et al (2008) Previous radiotherapy negatively influences quality of life during 4 years of follow-up in patients cured from acromegaly. Clin Endocrinol (Oxf) 69:123–128

    Article  Google Scholar 

  15. Anagnostis P, Efstathiadou ZA, Charizopoulou M et al (2014) Psychological profile and quality of life in patients with acromegaly in Greece. Is there any difference with other chronic diseases? Endocrine 47:564–571

    Article  CAS  PubMed  Google Scholar 

  16. Webb SM, Prieto L, Badia X et al (2002) Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol (Oxf) 57:251–258

    Article  CAS  Google Scholar 

  17. Melmed S (2006) Medical progress: acromegaly. N Engl J Med 355:2558–2573

    Article  CAS  PubMed  Google Scholar 

  18. Katznelson L, Atkinson JL, Cook DM et al (2011) American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly—2011 update. Endocr Pract 17(Suppl. 4):1–44

    Article  PubMed  Google Scholar 

  19. Terzolo M, Reimondo G, Gasperi M et al (2005) Colonoscopic screening and follow-up in patients with acromegaly: a multicenter study in Italy. J Clin Endocrinol Metab 90:84–90

    Article  CAS  PubMed  Google Scholar 

  20. Isojima T, Shimatsu A, Yokoya S et al (2012) Standardized centile curves and reference intervals of serum insulin-like growth factor-I (IGF-I) levels in a normal Japanese population using the LMS method. Endocr J 59:771–780

    Article  CAS  PubMed  Google Scholar 

  21. Giustina A, Chanson P, Bronstein MD et al (2010) A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab 95:3141–3148

    Article  CAS  PubMed  Google Scholar 

  22. Fukuhara S, Bito S, Green J et al (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51:1037–1044

    Article  CAS  PubMed  Google Scholar 

  23. Suzukamo Y, Fukuhara S, Green J et al (2011) Validation testing of a three-component model of Short Form-36 scores. J Clin Epidemiol 64:301–308

    Article  PubMed  Google Scholar 

  24. Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334

    Article  Google Scholar 

  25. Nunnally JC, Bernstein IH (1978) Psychometric theory, 2nd edn. McGraw-Hill, New York

    Google Scholar 

  26. T’Sjoen G, Bex M, Maiter D et al (2007) Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian registry on acromegaly. Eur J Endocrinol 157:411–417

    Article  PubMed  Google Scholar 

  27. Matta MP, Couture E, Cazals L et al (2008) Impaired quality of life of patients with acromegaly: control of GH/IGF-I excess improves psychological subscale appearance. Eur J Endocrinol 158:305–310

    Article  CAS  PubMed  Google Scholar 

  28. Kepicoglu H, Hatipoglu E, Bulut I et al (2014) Impact of treatment satisfaction on quality of life of patients with acromegaly. Pituitary 17:557–563

    Article  PubMed  Google Scholar 

  29. Tiemensma J, Kaptein AA, Pereira AM et al (2011) Affected illness perceptions and the association with impaired quality of life in patients with long-term remission of acromegaly. J Clin Endocrinol Metab 96:3550–3558

    Article  CAS  PubMed  Google Scholar 

  30. Tiemensma J, Biermasz NR, van der Mast RC et al (2010) Increased psychopathology and maladaptive personality traits, but normal cognitive functioning, in patients after long-term cure of acromegaly. J Clin Endocrinol Metab 95:E392–E402

    Article  CAS  PubMed  Google Scholar 

  31. Sievers C, Dimopoulou C, Pfister H et al (2009) Prevalence of mental disorders in acromegaly: a cross-sectional study in 81 acromegalic patients. Clin Endocrinol (Oxf) 71:691–701

    Article  Google Scholar 

  32. Fathalla H, Cusimano MD, Alsharif OM et al (2014) Endoscopic transphenoidal surgery for acromegaly improves quality of life. Can J Neurol Sci 41:735–741

    Article  PubMed  Google Scholar 

  33. Gurel MH, Bruening PR, Rhodes C et al (2014) Patient perspectives on the impact of acromegaly: results from individual and group interviews. Patient Prefer Adherence 8:53–62

    PubMed Central  PubMed  Google Scholar 

  34. Otani R, Fukuhara N, Ochi T et al (2012) Rapid growth hormone measurement during transsphenoidal surgery: analysis of 252 acromegalic patients. Neurol Med Chir (Tokyo) 52:558–562

    Article  Google Scholar 

  35. Melmed S, Cook D, Schopohl J et al (2010) Rapid and sustained reduction of serum growth hormone and insulin-like growth factor-1 in patients with acromegaly receiving lanreotide Autogel therapy: a randomized, placebo-controlled, multicenter study with a 52 week open extension. Pituitary 13:18–28

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Tutuncu Y, Berker D, Isik S et al (2012) Comparison of octreotide LAR and lanreotide autogel as post-operative medical treatment in acromegaly. Pituitary 15:398–404

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  37. Postma MR, Netea-Maier RT, van den Berg G et al (2012) Quality of life is impaired in association with the need for prolonged postoperative therapy by somatostatin analogs in patients with acromegaly. Eur J Endocrinol 166:585–592

    Article  CAS  PubMed  Google Scholar 

  38. Giustina A, Chanson P, Kleinberg D et al (2014) Expert consensus document: a consensus on the medical treatment of acromegaly. Nat Rev Endocrinol 10:243–248

    Article  CAS  PubMed  Google Scholar 

  39. Abu Dabrh AM, Mohammed K, Asi N et al (2014) Surgical interventions and medical treatments in treatment-naive patients with acromegaly: systematic review and meta-analysis. J Clin Endocrinol Metab 99:4003–4014

    Article  CAS  PubMed  Google Scholar 

  40. Brohede S, Wingren G, Wijma B et al (2015) Prevalence of body dysmorphic disorder among Swedish women: a population-based study. Compr Psychiatry 58:108–115

    Article  PubMed  Google Scholar 

  41. Harris DL, Carr AT (2001) Prevalence of concern about physical appearance in the general population. Br J Plast Surg 54:223–226

    Article  CAS  PubMed  Google Scholar 

  42. Champion VL, Wagner LI, Monahan PO et al (2014) Comparison of younger and older breast cancer survivors and age-matched controls on specific and overall quality of life domains. Cancer 120:2237–2246

    Article  PubMed Central  PubMed  Google Scholar 

  43. Kenzik KM, Martin MY, Fouad MN et al (2015) Health-related quality of life in lung cancer survivors: latent class and latent transition analysis. Cancer. doi:10.1002/cncr.29232

    Google Scholar 

  44. Chung JO, Cho DH, Chung DJ et al (2014) An assessment of the impact of type 2 diabetes on the quality of life based on age at diabetes diagnosis. Acta Diabetol 51:1065–1072

    Article  CAS  PubMed  Google Scholar 

  45. Bex M, Abs R, T’Sjoen G et al (2007) AcroBel—the Belgian registry on acromegaly: a survey of the ‘real-life’ outcome in 418 acromegalic subjects. Eur J Endocrinol 157:399–409

    Article  CAS  PubMed  Google Scholar 

  46. Minniti G, Jaffrain-Rea ML, Osti M et al (2005) The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas. Clin Endocrinol (Oxf) 62:210–216

    Article  Google Scholar 

  47. Erridge SC, Conkey DS, Stockton D et al (2009) Radiotherapy for pituitary adenomas: long-term efficacy and toxicity. Radiother Oncol 93:597–601

    Article  PubMed  Google Scholar 

  48. Raappana A, Pirila T, Ebeling T et al (2012) Long-term health-related quality of life of surgically treated pituitary adenoma patients: a descriptive study. ISRN Endocrinol 2012:675310

    PubMed Central  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Ms. K. Imura for excellent assistance. This work was supported in part by Grants-in-Aid for Scientific Research from the Japanese Ministry of Education Science, Culture, Sports, Science, and Technology (24790945, 23659477, 23591354, and 22591012), Grants-in-Aid for Scientific Research (research on hypothalamic-hypophyseal disorders) from the Ministry of Health, Labor and Welfare of Japan, Novo Nordisk, the Daiichi-Sankyo Foundation of Life Science, and the Naito Foundation.

Author information

Authors and Affiliations

  1. Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan

    Kenichi Yoshida, Ryusaku Matsumoto, Hironori Bando, Wataru Ogawa & Yutaka Takahashi

  2. Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Hidenori Fukuoka, Kentaro Suda, Hitoshi Nishizawa & Genzo Iguchi

  3. Endocrinology/Medicine Departments, Center for Biomedical Network Research on Rare Diseases (CIBERER Unit 747), ISCIII, Sant Pau Biomedical Research Institute, Hospital de Sant Pau Universitat Autònoma de Barcelona, C/Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain

    Susan M. Webb

Authors
  1. Kenichi Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hidenori Fukuoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ryusaku Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hironori Bando
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kentaro Suda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hitoshi Nishizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Genzo Iguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Wataru Ogawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Susan M. Webb
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yutaka Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidenori Fukuoka.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshida, K., Fukuoka, H., Matsumoto, R. et al. The quality of life in acromegalic patients with biochemical remission by surgery alone is superior to that in those with pharmaceutical therapy without radiotherapy, using the newly developed Japanese version of the AcroQoL. Pituitary 18, 876–883 (2015). https://doi.org/10.1007/s11102-015-0665-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-015-0665-2

Keywords

Search

Navigation