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THE LONG-TERM IMPACT OF UNCONTROLLED HORMONES

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The long-term effects of acromegaly are not only disabling but also disfiguring. Most acromegalic patients are diagnosed 4 to 10 years after the onset of changes in features, bone overgrowth, soft tissue swelling, fatigue, skin changes, and cardiovascular symptoms.1-3

Uncontrolled acromegaly leads to increased risk of complications2,3

After successful treatment of acromegaly, many symptoms associated with the disease decrease. Nevertheless, some physical changes (for example, in bone and cartilage) are often irreversible. These factors make acromegaly a disease with a considerable impact on health-related quality of life.4,5

The following are some of the most important physical effects in patients with acromegaly6:

  • Body image
  • Pain
  • Depression
  • Mood changes
  • Energy and strength level
  • Physical and mental drive

Mortality of Acromegaly

Patients with acromegaly have approximately 2x the risk of mortality compared with the general population. The main causes of mortality in acromegaly are4,7:

  • Cardiovascular disease (60%)
  • Respiratory disease (25%)
  • Malignancies (15%)

Causes of mortality4

Causes of mortality

High levels of GH and the presence of hypertension and heart disease are the main determinants of mortality. Control of GH and/or IGF-1 levels reduce(s) mortality rates, despite the coexisting complications.7

By lowering IGF-1 and GH levels, patients' mortality rates can be reduced to expected levels of the general population.7

References:
1. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, US Department of Health and Human Services. Acromegaly. Bethesda, MD: National Institutes of Health; 2008. NIH publication 08-3924. 2. Chanson P, Salenave S. Acromegaly. Orphanet J Rare Dis. 2008;3:1-17. 3. Melmed S. Medical progress: acromegaly. N Engl J Med. 2006;355(24):2558-2573. 4. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-152. 5. Schöfl C, Franz H, Grussendorf M, et al; participants of the German Acromegaly Register. Long-term outcome in patients with acromegaly: analysis of 1344 patients from the German Acromegaly Register. Eur J Endocrinol. 2013;168(1):39-47. 6. Badia X, Webb SM, Prieto L, Lara N. Acromegaly quality of life questionnaire (AcroQoL). Health Qual Life Outcomes. 2004;2:1-6. 7. Holdaway IM, Rajasoorya RC, Gamble GD. Factors influencing mortality in acromegaly. J Clin Endocrinol Metab. 2004;89(2):667-674.

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