L M Fatti1, B Cangiano1,2, G Vitale1,2, L Persani1,2, G Mantovani2,3, E Sala2,3, M Arosio2,3, P Maffei4, F Dassie4, M Mormando5, A Giampietro5, L Tanda6, E R Masiello6, E Nazzari7, D Ferone7, S Corbetta8,9, E Passeri9, F Guaraldi10, S Grottoli11, S Cannavò12,13, M L T Torre12, D Soranna14, A Zambon15, F Cavagnini16, M Scacchi17,18. 1. Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy. 2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 3. Endocrine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Department of Medicine-DIMED, University of Padua, Padua, Italy. 5. Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, 'A. Gemelli' University Hospital, Rome, Italy. 6. Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy. 7. Endocrinology Unit, Department of Internal Medicine and Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy. 8. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. 9. Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 10. Pituitary Unit, Department of Biomedical and Neuromotor Sciences, IRCCS Institute of Neurological Sciences of Bologna, University of Bologna, Bologna, Italy. 11. Department of Medical Sciences, University of Turin, Turin, Italy. 12. Department of Human Pathology, University of Messina, Messina, Italy. 13. Endocrine Unit, University Hospital of Messina, Messina, Italy. 14. Istituto Auxologico Italiano, IRCCS, Milan, Italy. 15. Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy. 16. Istituto Auxologico Italiano IRCCS, Center for Biomedical Research and Technology, Cusano Milanino, Milan, Italy. 17. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. massimo.scacchi@unimi.it. 18. Division of General Medicine, Istituto Auxologico Italiano, IRCCS, Ospedale S. Giuseppe, Strada Cadorna 90, 28824, Località Piancavallo, Oggebbio-Verbania, Italy. massimo.scacchi@unimi.it.
Abstract
PURPOSE: Arthropathy is a common and disabling complication of acromegaly. Since in this condition radiological findings rarely correspond to functional impairment, we elected to quantify in a large cohort of acromegalic patients: the degree of motor disability compared with data from general population, the impact of joint involvement on quality of life and work productivity, and to look for associated factors. METHODS: In 211 acromegalic patients, 131 with controlled disease and 80 with active disease, eight validated scales were used to evaluate the (i) prevalence and distribution of arthropathy, (ii) degree of motor disability and joint symptoms (VAS, AIMS symptoms and WOMAC), (iii) quality of life (AcroQoL and PASQ) and work capability (WPAI:GH) as consequences of joint complications. RESULTS: Using the WOMAC questionnaire, for which population based normative values are available, a significantly higher prevalence and severity of motor disability was detected in acromegalics compared to the general population from literature. The results provided by the different questionnaires turned out to be highly concordant. All measures of motor disability correlated both with impaired quality of life and motor disability and were worse in females and in patients with higher BMI. CONCLUSIONS: The questionnaires VAS, AIMS symptoms, and WOMAC (this latter both as a whole and with its functionality subscale), with their scores, proved to be the most adequate tools to evaluate motor disability and its consequences on both quality of life and work productivity in acromegaly. Female gender and higher BMI are associated with worse articular symptoms.
PURPOSE:Arthropathy is a common and disabling complication of acromegaly. Since in this condition radiological findings rarely correspond to functional impairment, we elected to quantify in a large cohort of acromegalicpatients: the degree of motor disability compared with data from general population, the impact of joint involvement on quality of life and work productivity, and to look for associated factors. METHODS: In 211 acromegalicpatients, 131 with controlled disease and 80 with active disease, eight validated scales were used to evaluate the (i) prevalence and distribution of arthropathy, (ii) degree of motor disability and joint symptoms (VAS, AIMS symptoms and WOMAC), (iii) quality of life (AcroQoL and PASQ) and work capability (WPAI:GH) as consequences of joint complications. RESULTS: Using the WOMAC questionnaire, for which population based normative values are available, a significantly higher prevalence and severity of motor disability was detected in acromegalics compared to the general population from literature. The results provided by the different questionnaires turned out to be highly concordant. All measures of motor disability correlated both with impaired quality of life and motor disability and were worse in females and in patients with higher BMI. CONCLUSIONS: The questionnaires VAS, AIMS symptoms, and WOMAC (this latter both as a whole and with its functionality subscale), with their scores, proved to be the most adequate tools to evaluate motor disability and its consequences on both quality of life and work productivity in acromegaly. Female gender and higher BMI are associated with worse articular symptoms.
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