Fatigue in acromegaly patients: a scoping review

TL;DR

This review explores how common and severe fatigue is in people with acromegaly and what factors and treatments are involved.

Contribution

The study provides a comprehensive overview of fatigue in acromegaly, highlighting gaps in understanding and management.

Findings

Fatigue prevalence in acromegaly patients ranges from 49% to 92%.

Factors influencing fatigue include sleep issues, comorbidities, and disease-specific traits.

Aerobic exercise and cognitive behavioral therapy are among interventions used.

Abstract

This scoping review systematically examines current evidence on fatigue in acromegaly patients, with a particular focus on incidence, risk factors, hazards, assessment tools and therapeutic interventions, to inform evidence-based interventions aimed at improving rehabilitation outcomes.

A scoping review was conducted following the PRISMA-ScR guidelines. We systematically searched five international databases (PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library) and three Chinese databases (CNKI [China National Knowledge Infrastructure], WanFang, and Sinomed) from their inception through June 21, 2025. The inclusion criteria included original studies investigating fatigue manifestations in patients with acromegaly, including epidemiological studies, psychometric validation reports, and intervention trials. The exclusion criterion was articles focused exclusively on pharmacological or surgical interventions without fatigue assessment. Two independent researchers performed literature screening, data extraction, and quality appraisal via standardized protocols.

A total of 20 studies were included (all English-language publications). The prevalence of fatigue in acromegaly patients is high, ranging from 49% to 92%. Objective fatigue assessment tools primarily involve electromyography (EMG) and isokinetic dynamometry of the knee joint. Subjective fatigue was evaluated with patient self-reports. Factors that influence fatigue in these patients include demographic characteristics, sociological factors, sleep disturbances, comorbidities, and disease-specific factors. Interventions included aerobic exercise, rehabilitation therapist-guided home rehabilitation programs, and cognitive behavioral therapy.

This scoping review underscores the need for future large-scale longitudinal studies on fatigue in acromegaly. Priority areas include identifying predictive markers, understanding pathophysiological mechanisms, evaluating targeted interventions, and developing standardized assessment tools to improve early recognition and management.

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