Morphometric changes correlate with poor psychological outcomes in patients with acromegaly (original) (raw)
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Facial Phenotype Changes and Its Impact in Quality of Life of Acromegaly Patients
2022
Purpose: to study the potential relationship between disfiguring facial modifications and psychosocial and Quality of Life (QoL) impact in a group of acromegaly patients. Methods: Thirty patients accepted to participate in this study (n=13) women and 56.6% (n=17) men; mean age was 61.1 ± 15.8 and 56.3 ± 12.4 years, respectively. Variables studied included: a) Anxiety level, measured through the State-Trait Anxiety Questionnaire (STAI); b) Quality of life evaluation by AcroQoL; c) Self-esteem status through the Rosemberg Self-Esteem Scale and d) Facial acromegaly phenotypic changes evaluated from face photographs and scored by 8 trained endocrinologists. Results: Gender differences were observed in Anxiety levels, with higher values in women than in men (trait: 6.1±2.2 and 5.0±2.0 (p=0.025); state: 8.2±1.1 and 3.1±2.1 (p=0.004), respectively. Also, there were differences in the global AcroQoL score, being 69.3 (SD±17.7) for males and 51.1 (SD±21.8) for females (p = 0.004) and it was ...
Frontiers in endocrinology, 2018
Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities. Cross sectional, multicentric. 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented. Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy pop...
Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition
European Journal of Clinical Investigation, 2012
Eur J Clin Invest 2012; 42 (12): 1317–1324Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF‐1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this study was to compare cognitive functioning of patients who are treated for acromegaly with patients with non‐functioning pituitary adenomas (NFA). In addition, we assessed the influence of prolonged medical treatment after initial transsphenoidal surgery on cognition.Design In this cross‐sectional study, 74 patients participated, who were treated for acromegaly (n = 50; median [interquartile range] age: 53 [45–65] years) or NFA (n = 24; age: 63 [59–70] years). The NFA patients were selected for a high likelihood of normal GH secretion based on an IGF‐1 z‐score within the normal range (> −2) and zero or one axis substituted. Of the acromegaly pa...
The Quality of Life and Psychological, Social and Cognitive Functioning of Patients with Acromegaly
Advances in Clinical and Experimental Medicine, 2015
Acromegaly is a rare and chronic disease, most often caused by a pituitary adenoma. Excessive secretion of the growth hormone (GH) leads to hepatic secretion of insulin-like growth factor-1 (IGF-1), which in turn causes characteristic changes in the patient's appearance, many skeletal deformities and metabolic disorders. In addition to somatic symptoms, acromegalic patients demonstrate psychosocial and personality deficits, as well as common co-occurrence of mental disorders. There are few studies investigating acromegaly in Poland. In recent years, the concept of quality of life has become fundamental to understanding health problems. Studies dealing with acromegaly likewise tend to include assessments of quality of life of patients suffering from this endocrinopathy.
Clinical Endocrinology, 1998
OBJECTIVE Acromegaly is associated with reduced life expectancy, while therapeutic 'cure' (defined by achievement of GH levels <5 mU/l) is associated with normalization of life expectancy. Surgery remains the treatment of choice but in those in whom operative 'cure' is not achieved, radiotherapy and/or medical treatment are valuable treatment modalities. The chance of subsequent 'cure' with radiotherapy or somatostatin analogue therapy is increased if the post-operative GH level is reduced below 30 mU/l. Using strict criteria for cure and a single dedicated pituitary surgeon, two large European studies reported 'cure' rates of 42% and 56%. In the Manchester region, surgery for these patients has been performed by a number of neurosurgeons, with no specific designated pituitary surgeon dominating the picture. We wished to examine the impact of this surgical strategy on cure rates and the incidence of a post-operative GH level below 30 mU/l. DESIGN We reviewed the GH results between 1974 and 1997 for every acromegalic who had been referred to the endocrine departments of the two Manchester hospitals responsible for the majority of pituitary disease referrals in Manchester and who had been subsequently referred for pituitary surgery. PATIENTS AND MEASUREMENTS Seventy-three (33 male) patients had had GH status assessed before and after surgery by an OGTT or GH profile. The
Pituitary, 2015
Follow-up management of patients with acromegaly after pituitary surgery is performed by conducting biochemical assays of growth hormone (GH) and insulin-like growth factor-1 (IGF1). Despite concordant results of these two tests in the majority of cases, there is increasing recognition of patients who show persistent or intermittent discordance between GH and IGF1 (normal GH and elevated IGF1 or vice versa). In this narrative review, the last three decades materials on the issue of discrepancy between GH and IGF1 were thoroughly assessed. Various studies have obtained different discordance rates, ranging from 5.4 to 39.5%. At present, despite the use of current sensitive assays and more stringent criteria to define remission, the rate of discordance still remains high. A number of mechanisms have been proposed to explain the postoperative discordance of GH and IGF1 including; altered dynamics of the GH secretion after surgery, early postoperative hormone assay, inaccurate or less se...
Self-Image in Patients with Acromegaly: A Cross-Sectional Study in Brazil
Psicologia, Saúde & Doença, 2020
A acromegalia é caracterizada pelo excesso do hormônio de crescimento (GH) em adultos entre 30 e 50 anos. A doença apresenta manifestações clínicas, como crescimento das extremidades e assimetria facial. O principal objetivo do estudo foi descrever os impactos psicossociais das alterações físicas da acromegalia na autoimagem. Foi realizado um estudo retrospectivo de corte transversal em uma amostra de 71 pacientes do estado da Bahia, utilizando o questionário AcroQol (Questionário de Qualidade de Vida em Acromegalia). Foi utilizada também a técnica de grupo focal, onde a partir de uma análise de conteúdo foram explorados aspectos psicossociais. Os participantes de ambos os gêneros, em sua maioria, se veem diferentes no espelho e percebem que há partes no corpo que são demasiado grandes por conta da patologia. Já boa parte das mulheres se percebem feias e se veem horrorosas nas fotografias, enquanto mais da metade dos homens percebem o olhar do outro por conta do seu aspecto físico. Os resultados qualitativos indicaram, como maior incômodo as mudanças físicas em relação a outras manifestações clínicas, pois impactam em áreas da vida como a emocional e laboral. Foi evidenciado o impacto que a alteração na autoimagem pode trazer a nível social, psicológico e emocional na vida do acromegálico.