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Growth Hormone Deficiency Is Associated with Decreased Quality of Life in Patients with Prior Acromegaly

Neuroendocrine Unit (T.W., L.G., Z.O., C.B., G.G., A.L.U., B.B., L.N., A.K., K.K.M.) and Center for Pediatric and Adolescent Health Policy (K.K.), Department of Pediatrics; Department of Radiation Oncology (J.L.); and Department of Neurosurgery (B.S.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114

Address all correspondence and requests for reprints to: Karen K. Miller, Neuroendocrine Unit, Bulfinch 457B, Massachusetts General Hospital, Boston, Massachusetts 02114. E-mail: KKMiller{at}Partners.org.

Context: Both GH deficiency (GHD) and GH excess are associated with a decreased quality of life. However, it is unknown whether patients with GHD after treatment for acromegaly have a poorer quality of life than those with normal GH levels after cure of acromegaly.

Objective: The aim of the study was to determine whether patients with GHD and prior acromegaly have a poorer quality of life than those with GH sufficiency after cure of acromegaly.

Design and Setting: We conducted a cross-sectional study in a General Clinical Research Center.

Study Participants: Forty-five patients with prior acromegaly participated: 26 with GHD and 19 with GH sufficiency.

Intervention: There were no interventions.

Main Outcome Measures: We evaluated quality of life, as measured by 1) the Quality of Life Adult Growth Hormone Deficiency Assessment (QoL-AGHDA); 2) the Short-Form Health Survey (SF-36); and 3) the Symptom Questionnaire.

Results: Mean scores on all subscales of all questionnaires, except for the anger/hostility and anxiety subscales of the Symptom Questionnaire, showed significantly impaired quality of life in the GH-deficient group compared with the GH-sufficient group. Peak GH levels after GHRH-arginine stimulation levels were inversely associated with QoL-AGHDA scale scores (R = –0.53; P = 0.0005) and the Symptom Questionnaire Depression subscale scores (R = –0.35; P = 0.031) and positively associated with most SF-36 subscale scores.

Conclusions: Our data are the first to demonstrate a reduced quality of life in patients who develop GHD after cure of acromegaly compared to those who are GH sufficient. Further studies are warranted to determine whether GH replacement would improve quality of life for patients with GHD after cure from acromegaly.