MON-062 - Quality of Life and Life Satisfaction in Panhypopituitarism: Determinants of Patient-Reported Outcomes in an Indian Cohort

Background: Panhypopituitarism is a chronic, multisystem disorder that profoundly affects patients’ functional, emotional, and social well-being. Despite its burden, the Indian literature evaluating quality of life (QoL) in such patients is virtually absent. This study aims to assess QoL, life satisfaction, fatigue, and psychological health in Indian patients with panhypopituitarism due to non-secretory sellar tumors and identify predictors of impaired well-being.

Objectives:
To assess quality of life, fatigue, life satisfaction, and psychological well-being in patients with panhypopituitarism due to non-secretory sellar and suprasellar tumors, and to identify clinical and hormonal predictors of impaired QoL.

Methods:
A cross-sectional case-control study was conducted on 64 patients with biochemically confirmed panhypopituitarism and 54 matched healthy controls. Patients were evaluated using SF-36, QLS-H (Hindi version), MFI-20, and PHQ-2. Hormonal, clinical, and radiological parameters were analyzed to identify predictors of QoL using correlation and multivariate regression.

Results: Compared to controls, patients had significantly lower SF-36 scores (49.76±9.61 vs. 54.22±9.43; p=0.009), higher fatigue (MFI-20: 58.24±11.18 vs. 53.09±10.42; p=0.008), and lower life satisfaction (QLS-H: 1.675±0.322 vs. 1.300±0.129; p< 0.001). IGF-1 independently predicted SF-36 domains including physical function and emotional role limitation. Low initial testosterone and T4 levels were associated with worse fatigue and emotional health. Higher glucocorticoid and levothyroxine doses were associated with lower mental health and higher depression scores. The Hindi version of QLS-H was successfully validated with strong construct and test-retest reliability. While three-split hydrocortisone regimens were associated with higher total daily doses and greater weight gain, no significant improvement in overall QoL scores was observed compared to two-split regimens.

Conclusions: Panhypopituitarism severely compromises quality of life even with replacement therapy. IGF-1 and testosterone levels emerged as critical, modifiable predictors. This study—first of its kind in India—underscores the need for individualized hormone titration and psycho-social support. Validating the Hindi QLS-H further bridges a vital gap in QoL assessment in Indian patients. Optimizing thyroxine and sex steroid replacement while avoiding supraphysiological glucocorticoid exposure may improve long-term well-being, as higher doses and more frequent glucocorticoid regimens did not confer QoL benefit.

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