Endocrine Abstracts

Acromegaly is a rare disease usually diagnosed late in disease evolution. It implies for skeletal changes of most flat bones including those of the skull. Consequently, a progressive facial disfiguration occurs at slow velocity of irreversible nature. Even after curation most of these changes stay for the whole life of the patient.

Aim: to study the potential relationship between disfiguring facial modifications and psychosocial and Quality of Life (QoL) impact in a group of acromegaly patients.

Patients and methods: Thirty patients accepted to participate in this study (13 women and 17 men); mean age was 61.1 ± 15.8 and 56.3 ± 12.4 years, respectively. Variables studied included: a) Anxiety level, measured through the State-Trait Anxiety Questionnaire (STAI); b) Quality of life evaluation by AcroQoL; c) Self-esteem status through the Rosemberg Self-Esteem Scale and d) Facial acromegaly phenotypic changes evaluated from face photographs and scored by 8 trained endocrinologists. Results: There were gender differences in anxiety levels, with higher values in women than in men (trait: 6.1±2.2 and 5.0±2.0 (P=0.025); state: 8.2±1.1 and 3.1±2.1 (P=0.004), respectively. Also, there were differences in the Global AcroQoL score: 69.3 ± 17.7 for males and 51.1 ± 21.8 for females (P=0.004) and this was reflected in all dimensions. Self-esteem was similar in both groups. There were lower scoring values for the face appearance in women at pre-diagnostic phase compoared to men (3.4±1.3 vs. 4.75±1.5). A negative correlation between self-esteem and changes in facial scores at the pre-diagnostic and diagnostic periods (r_s=-0.559, P=0.074) was found, consistent with a high impact of facial changes in the psychologic status of the patients. Conclusion: acromegaly facial changes negatively impact the psychosocial condition of these patients with maximal deleterious effects at the time of diagnosis; these disturbances persist over time despite cure or hormonal control and are of higher intensity in women.