Recently, Webb et al. (6) published a validated, diseasespecific
questionnaire with special attention to problems
present in patients with acromegaly, as assessed by structured
interviews. To date, this questionnaire has been used
in 22 Turkish patients with active (n 10) and inactive (n
12) acromegaly, and the total score was reported to be lower
in active patients than in inactive patients (48.4 13.1 vs.
70.8 14.3). In addition, the total score correlated inversely
with serum IGF-I concentrations and a validated depression
questionnaire (Beck’s depression inventory). We found comparable
scores for the ACRO-QOL total score in our treated
patients as Deyneli et al. (22) found in their inactive patients.
Interestingly, in our study lower scores on the personal relation
subscale of the ACRO-QOL were also associated with
a longer disease duration after adjustment for age. Further
investigation is required to assess the value of the ACROQOL
as a clinical follow-up parameter for evaluating the
efficacy of treatment.
The SF-36 was recently recommended for use in GH deficiency
and is now increasingly used in pituitary disease (23).
This questionnaire may be more sensitive to detect changes in
quality of life in GH deficiency and replacement studies than
the most frequently used NHP questionnaire. In this study
NHP scores were indeed influenced by the age of the patient,
and we found some discrepancies between NHP and the other
questionnaires; this may be a reflection of the lower sensitivity
due to the yes/no questions. Nondisease-specific quality of life
surveys were conducted with 27 newly diagnosed acromegalic
patients by Johnson et al. (24) using the SF-36. Physical function,
role limitations (physical), general health, vitality, and physical
summary scores were lower than those in a reference population,
although quality of life in acromegaly was less affected
than that in patients with Cushing’s disease. When comparing
the SF-36 results of the patients of Johnson et al. (24) with active
acromegaly and our cohort of treated patients, perceived wellbeing
seems to be improved after establishment of remission.
The SF-36 was also used to compare quality of life in patients
who underwent surgery for nonfunctioning pituitary tumors
and patients with mastoid surgery in the history as controls;
thus, those without pituitary disease, but with comparable
medical intervention (25). In these groups identical results were
found even in those patients with suspected GH deficiency.
Interestingly, our patients scored worse than either group in the
study by Page et al. (25) on the physical subscales, pain and
health perception, but not on the emotional role and social
functioning subscales (Table 5).