Beyond biochemical control: factors associated with quality of life in patients with acromegaly

Quality of life (QoL) impairment may persist in acromegaly despite biochemical control. We evaluated disease-specific and generic QoL, psychological symptom burden, and associated factors.

In this cross-sectional study, 90 patients completed the Acromegaly Quality of Life Questionnaire (AcroQoL), EQ-5D-3 L, EQ-VAS, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Demographic, clinical, biochemical, and treatment-related data were retrieved from records. Correlation analyses and hierarchical multivariable linear regression were used to assess factors associated with total AcroQoL.

The cohort included 46 female and 44 male patients; 86 were in biochemical remission. Median total AcroQoL, BDI, BAI, EQ-5D index, and EQ-VAS scores were 76.7, 10.5, 9.0, 0.7, and 80.0, respectively. Female patients had lower total AcroQoL scores and higher anxiety and depression scores than male patients. Higher educational status was associated with better AcroQoL and lower BDI scores. In Model 1, female sex was associated with lower total AcroQoL; however, this association became non-significant after moderate-to-severe depressive symptoms were added in Model 2. Depressive symptom status showed the largest independent association with lower total AcroQoL among model variables (B = - 17.56, 95% CI - 25.23 to - 9.89, p < 0.001), while higher educational status remained independently associated with better QoL. R^² increased from 0.206 to 0.365.

In this predominantly biochemically controlled cohort, disease-specific QoL was more closely associated with depressive symptom burden and educational status than with the clinical variables examined. These findings support routine assessment of psychological symptoms and patient-reported outcomes during long-term care.