SAGIT<b><sup>?</sup></b> diagnostic evaluation tool system improves the diagnosis and management of acromegaly_West China Medical Journal

Authors：

 TAN Huiwen

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

TAN Huiwen, Email: huiwent2016@scu.edu.cn

Keywords：

Acromegaly; SAGIT^{assessment system;} clinician-reported outcome; disease activity; treatment decision; whole-course management

DOI：

10.7507/1002-0179.202512373

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

The treatment goal for acromegaly has shifted from just hitting biochemical targets of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) remission to a long-term, comprehensive improvement that also considers hormones, metabolic regulations, tumor, symptoms, comorbidities, and patient experience. The SAGIT^? assessment system, as the first multi-dimensional clinician-reported outcome tool, integrates five aspects: signs and symptoms (S), associated comorbidities (A), GH levels (G), IGF-1 levels (I), and tumor profile (T). It enables quantitative scoring and dynamic stratification of disease severity. International prospective validation studies have shown that each SAGIT^? dimension has good discriminatory ability for disease control; a 2025 multicenter study indicated that SAGIT^? objectively reflects disease activity. This article systematically reviews the limitations of existing assessment tools, explains the design principles and scoring criteria of SAGIT^?, and discusses its clinical value in disease staging, treatment decision-making, efficacy prediction, and follow-up management. Furthermore, it explores future directions for improving SAGIT^? and other disease rating tools, including artificial intelligence integration, development of dynamic monitoring modules, and validation and application in Chinese patients with acromegaly.

Citation： TAN Huiwen. SAGIT^? diagnostic evaluation tool system improves the diagnosis and management of acromegaly. West China Medical Journal, 2026, 41(9): 1559-1564. doi: 10.7507/1002-0179.202512373 Copy

1.	Weinreb J, Arora S. Acromegaly[J]. N Engl J Med, 2023, 388(1): 70.
2.	Ershadinia N, Tritos NA. Diagnosis and treatment of acromegaly: an update[J]. Mayo Clin Proc, 2022, 97(2): 333-346.
3.	Moustaki M, Paschou SA, Xekouki P, et al. Secondary diabetes mellitus in acromegaly[J]. Endocrine, 2023, 81(1): 1-15.
4.	Esposito D, Boguszewski CL, Colao A, et al. Diabetes mellitus in patients with acromegaly: pathophysiology, clinical challenges and management[J]. Nat Rev Endocrinol, 2024, 20(9): 541-552.
5.	Kasuki L, Antunes X, Lamback EB, et al. Acromegaly: update on management and long-term morbidities[J]. Endocrinol Metab Clin North Am, 2020, 49(3): 475-486.
6.	Maffezzoni F, Porcelli T, Delbarba A, et al. Biomarkers of acromegaly and growth hormone action[J]. Protein Pept Lett, 2020, 27(12): 1231-1245.
7.	Fleseriu M, Langlois F, Lim DST, et al. Acromegaly: pathogenesis, diagnosis, and management[J]. Lancet Diabetes Endocrinol, 2022, 10(11): 804-826.
8.	Giustina A, Bevan J, Bronstein M, et al. Sagit?: A novel clinician-reported outcome for managing acromegaly in clinical practice[J]. Value Health, 2014, 17(7): A355.
9.	Ware JE, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) project[J]. J Clin Epidemiol, 1998, 51(11): 903-912.
10.	Ferreira PL, Antunes P, Ferreira LN, et al. A hybrid modelling approach for eliciting health state preferences: the Portuguese EQ-5D-5L value set[J]. Qual Life Res, 2019, 28(12): 3163-3175.
11.	Wu Y, Fu C, Zhang W, et al. The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients[J]. Psychol Health Med, 2018, 23(4): 369-374.
12.	Badia X, Webb SM, Prieto L, et al. Acromegaly Quality of Life Questionnaire (AcroQoL)[J]. Health Qual Life Outcomes, 2004, 2: 13.
13.	Webb SM. Quality of life in acromegaly[J]. Neuroendocrinology, 2006, 83(3/4): 224-229.
14.	Kocaman BB, Cicek Y, Sahin S, et al. Psychological profiles of patients with acromegaly: personality traits, quality of life, and clinical correlates[J]. Pituitary, 2025, 29(1): 24.
15.	Gandhi C, Denis MC, Holmes D, et al. Impact of strict IGF1 control on quality-of-life scores in patients with acromegaly[J]. Front Endocrinol (Lausanne), 2025, 16: 1516899.
16.	Martínez-Momblán MA, Alonso-Fernández S, Marques-Pamies M, et al. Quality of life and psychological status in people with acromegaly in relation to facial changes[J]. Endocr Connect, 2025, 14(5): e240545.
17.	Coopmans EC, Andela CD, Claessen KMJA, et al. Evaluating the impact of acromegaly on quality of life[J]. Endocrinol Metab Clin North Am, 2022, 51(4): 709-725.
18.	焦蕤, 段煉, 朱惠娟, 等. 肢端肥大癥患者生活質量相關研究新進展[J]. 中華醫學雜志, 2021, 101(30): 2417-2420.
19.	Giustina A, Bronstein MD, Chanson P, et al. International multicenter validation study of the SAGIT^? instrument in acromegaly[J]. J Clin Endocrinol Metab, 2021, 106(12): 3555-3568.
20.	Sawicka-Gutaj N, Zió?kowska P, Biczysko A, et al. The potential utility of the SAGIT instrument in the clinical assessment of patients with acromegaly, a large single-centre study[J]. Sci Rep, 2023, 13(1): 3286.
21.	Nú?ez-Martínez FJ, Chávez-Lárraga AJ, Hernández-Salazar E, et al. Efficacy of octreotide LAR and lanreotide autogel in acromegaly assessed by SAGIT[J]. Rev Med Inst Mex Seguro Soc, 2026, 64(3): e6706.
22.	Giustina A, Barkan A, Beckers A, et al. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update[J]. J Clin Endocrinol Metab, 2020, 105(4): dgz096.
23.	Giustina A, Bronstein MD, Chanson P, et al. Staging and managing patients with acromegaly in clinical practice: baseline data from the SAGIT^? validation study[J]. Pituitary, 2019, 22(5): 476-487.
24.	Trepp R, Everts R, Stettler C, et al. Assessment of quality of life in patients with uncontrolled vs. controlled acromegaly using the Acromegaly Quality of Life Questionnaire (AcroQoL)[J]. Clin Endocrinol (Oxf), 2005, 63(1): 103-110.
25.	Chanson P. SAGIT?, ACRODAT?, PANOMEN 3… time to implement tools for management of acromegaly.?[J]. Pituitary, 2025, 28(6): 110.
26.	Camerini S, Wennberg A, Adriani M, et al. Questionnaire and tools: clinical powerful instrument in acromegaly diagnosis and management[J]. J Endocrinol Invest, 2022, 45(10): 1823-1834.
27.	Dassie F, Ceccato F, Sartorato P, et al. ACRODAT and SAGIT for the assessment of disease activity in acromegaly: a multicenter study of the Veneto region in Italy[J]. Pituitary, 2025, 28(4): 76.
28.	Wang W, Yang T, Huang Q. Quality of life in patients with acromegaly: a scoping review[J]. Orphanet J Rare Dis, 2024, 19(1): 251.
29.	Giustina A, Biermasz N, Casanueva FF, et al. Consensus on criteria for acromegaly diagnosis and remission[J]. Pituitary, 2024, 27(1): 7-22.
30.	Leonart LP, Borba HHL, Ferreira VL, et al. Cost-effectiveness of acromegaly treatments: a systematic review[J]. Pituitary, 2018, 21(6): 642-652.
31.	Fookeerah P, Varikatt W, Shingde M, et al. Assessing the clinical application of the PANOMEN 3 classification in a large cohort of pituitary tumors[J]. Eur J Endocrinol, 2025, 193(1): 56-64.
32.	Herman R, Gori?ar K, Jane? A, et al. Clinical applicability of patient- and clinician-reported outcome tools in the management of patients with acromegaly[J]. Endocr Pract, 2022, 28(7): 678-683.
33.	Sawicka-Gutaj N, Derwich-Rudowicz A, Biczysko A, et al. Serum phosphorus and calcium as biomarkers of disease status in acromegaly[J]. Biomedicines, 2023, 11(12): 3278.
34.	Marazuela M, Blanco C, Bernabeu I, et al. Acromegaly disease activity according to ACRODAT^?, a cross-sectional study in Spain: ACROVAL study[J]. Endocrine, 2022, 75(2): 525-536.
35.	Emmanouilidis D, Polanski W, Juratli T, et al. Predictive factors for post-therapeutic biochemical discordance in acromegaly: a monocentric analysis of 156 cases[J]. Pituitary, 2025, 28(4): 74.
36.	Friedel AL, Schock L, Siegel S, et al. Shared decision-making and detection of comorbidities in an online acromegaly consultation with and without the Acromegaly Disease Activity Tool ACRODAT^? using the simulated person approach[J]. Pituitary, 2024, 27(5): 545-554.
37.	Gezer E, ?etinarslan B, Cantürk Z, et al. May the SAGIT^? instrument be used as a preoperative prognostic tool in patients with acromegaly?[J]. Minerva Endocrinol (Torino), 2025, 50(1): 24-31.
38.	Melmed S, di Filippo L, Fleseriu M, et al. Consensus on acromegaly therapeutic outcomes: an update[J]. Nat Rev Endocrinol, 2025, 21(11): 718-737.

1. Weinreb J, Arora S. Acromegaly[J]. N Engl J Med, 2023, 388(1): 70.
2. Ershadinia N, Tritos NA. Diagnosis and treatment of acromegaly: an update[J]. Mayo Clin Proc, 2022, 97(2): 333-346.
3. Moustaki M, Paschou SA, Xekouki P, et al. Secondary diabetes mellitus in acromegaly[J]. Endocrine, 2023, 81(1): 1-15.
4. Esposito D, Boguszewski CL, Colao A, et al. Diabetes mellitus in patients with acromegaly: pathophysiology, clinical challenges and management[J]. Nat Rev Endocrinol, 2024, 20(9): 541-552.
5. Kasuki L, Antunes X, Lamback EB, et al. Acromegaly: update on management and long-term morbidities[J]. Endocrinol Metab Clin North Am, 2020, 49(3): 475-486.
6. Maffezzoni F, Porcelli T, Delbarba A, et al. Biomarkers of acromegaly and growth hormone action[J]. Protein Pept Lett, 2020, 27(12): 1231-1245.
7. Fleseriu M, Langlois F, Lim DST, et al. Acromegaly: pathogenesis, diagnosis, and management[J]. Lancet Diabetes Endocrinol, 2022, 10(11): 804-826.
8. Giustina A, Bevan J, Bronstein M, et al. Sagit?: A novel clinician-reported outcome for managing acromegaly in clinical practice[J]. Value Health, 2014, 17(7): A355.
9. Ware JE, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) project[J]. J Clin Epidemiol, 1998, 51(11): 903-912.
10. Ferreira PL, Antunes P, Ferreira LN, et al. A hybrid modelling approach for eliciting health state preferences: the Portuguese EQ-5D-5L value set[J]. Qual Life Res, 2019, 28(12): 3163-3175.
11. Wu Y, Fu C, Zhang W, et al. The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients[J]. Psychol Health Med, 2018, 23(4): 369-374.
12. Badia X, Webb SM, Prieto L, et al. Acromegaly Quality of Life Questionnaire (AcroQoL)[J]. Health Qual Life Outcomes, 2004, 2: 13.
13. Webb SM. Quality of life in acromegaly[J]. Neuroendocrinology, 2006, 83(3/4): 224-229.
14. Kocaman BB, Cicek Y, Sahin S, et al. Psychological profiles of patients with acromegaly: personality traits, quality of life, and clinical correlates[J]. Pituitary, 2025, 29(1): 24.
15. Gandhi C, Denis MC, Holmes D, et al. Impact of strict IGF1 control on quality-of-life scores in patients with acromegaly[J]. Front Endocrinol (Lausanne), 2025, 16: 1516899.
16. Martínez-Momblán MA, Alonso-Fernández S, Marques-Pamies M, et al. Quality of life and psychological status in people with acromegaly in relation to facial changes[J]. Endocr Connect, 2025, 14(5): e240545.
17. Coopmans EC, Andela CD, Claessen KMJA, et al. Evaluating the impact of acromegaly on quality of life[J]. Endocrinol Metab Clin North Am, 2022, 51(4): 709-725.
18. 焦蕤, 段煉, 朱惠娟, 等. 肢端肥大癥患者生活質量相關研究新進展[J]. 中華醫學雜志, 2021, 101(30): 2417-2420.
19. Giustina A, Bronstein MD, Chanson P, et al. International multicenter validation study of the SAGIT^? instrument in acromegaly[J]. J Clin Endocrinol Metab, 2021, 106(12): 3555-3568.
20. Sawicka-Gutaj N, Zió?kowska P, Biczysko A, et al. The potential utility of the SAGIT instrument in the clinical assessment of patients with acromegaly, a large single-centre study[J]. Sci Rep, 2023, 13(1): 3286.
21. Nú?ez-Martínez FJ, Chávez-Lárraga AJ, Hernández-Salazar E, et al. Efficacy of octreotide LAR and lanreotide autogel in acromegaly assessed by SAGIT[J]. Rev Med Inst Mex Seguro Soc, 2026, 64(3): e6706.
22. Giustina A, Barkan A, Beckers A, et al. A consensus on the diagnosis and treatment of acromegaly comorbidities: an update[J]. J Clin Endocrinol Metab, 2020, 105(4): dgz096.
23. Giustina A, Bronstein MD, Chanson P, et al. Staging and managing patients with acromegaly in clinical practice: baseline data from the SAGIT^? validation study[J]. Pituitary, 2019, 22(5): 476-487.
24. Trepp R, Everts R, Stettler C, et al. Assessment of quality of life in patients with uncontrolled vs. controlled acromegaly using the Acromegaly Quality of Life Questionnaire (AcroQoL)[J]. Clin Endocrinol (Oxf), 2005, 63(1): 103-110.
25. Chanson P. SAGIT?, ACRODAT?, PANOMEN 3… time to implement tools for management of acromegaly.?[J]. Pituitary, 2025, 28(6): 110.
26. Camerini S, Wennberg A, Adriani M, et al. Questionnaire and tools: clinical powerful instrument in acromegaly diagnosis and management[J]. J Endocrinol Invest, 2022, 45(10): 1823-1834.
27. Dassie F, Ceccato F, Sartorato P, et al. ACRODAT and SAGIT for the assessment of disease activity in acromegaly: a multicenter study of the Veneto region in Italy[J]. Pituitary, 2025, 28(4): 76.
28. Wang W, Yang T, Huang Q. Quality of life in patients with acromegaly: a scoping review[J]. Orphanet J Rare Dis, 2024, 19(1): 251.
29. Giustina A, Biermasz N, Casanueva FF, et al. Consensus on criteria for acromegaly diagnosis and remission[J]. Pituitary, 2024, 27(1): 7-22.
30. Leonart LP, Borba HHL, Ferreira VL, et al. Cost-effectiveness of acromegaly treatments: a systematic review[J]. Pituitary, 2018, 21(6): 642-652.
31. Fookeerah P, Varikatt W, Shingde M, et al. Assessing the clinical application of the PANOMEN 3 classification in a large cohort of pituitary tumors[J]. Eur J Endocrinol, 2025, 193(1): 56-64.
32. Herman R, Gori?ar K, Jane? A, et al. Clinical applicability of patient- and clinician-reported outcome tools in the management of patients with acromegaly[J]. Endocr Pract, 2022, 28(7): 678-683.
33. Sawicka-Gutaj N, Derwich-Rudowicz A, Biczysko A, et al. Serum phosphorus and calcium as biomarkers of disease status in acromegaly[J]. Biomedicines, 2023, 11(12): 3278.
34. Marazuela M, Blanco C, Bernabeu I, et al. Acromegaly disease activity according to ACRODAT^?, a cross-sectional study in Spain: ACROVAL study[J]. Endocrine, 2022, 75(2): 525-536.
35. Emmanouilidis D, Polanski W, Juratli T, et al. Predictive factors for post-therapeutic biochemical discordance in acromegaly: a monocentric analysis of 156 cases[J]. Pituitary, 2025, 28(4): 74.
36. Friedel AL, Schock L, Siegel S, et al. Shared decision-making and detection of comorbidities in an online acromegaly consultation with and without the Acromegaly Disease Activity Tool ACRODAT^? using the simulated person approach[J]. Pituitary, 2024, 27(5): 545-554.
37. Gezer E, ?etinarslan B, Cantürk Z, et al. May the SAGIT^? instrument be used as a preoperative prognostic tool in patients with acromegaly?[J]. Minerva Endocrinol (Torino), 2025, 50(1): 24-31.
38. Melmed S, di Filippo L, Fleseriu M, et al. Consensus on acromegaly therapeutic outcomes: an update[J]. Nat Rev Endocrinol, 2025, 21(11): 718-737.

Previous Article
Research status and progress on health behavior decision-making in patients with liver cancer
Next Article
TIME 框架聯合病因治療難治性下肢潰瘍三例

West China Medical Journal

SAGIT^? diagnostic evaluation tool system improves the diagnosis and management of acromegaly

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content

West China Medical Journal

SAGIT? diagnostic evaluation tool system improves the diagnosis and management of acromegaly

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content

SAGIT^? diagnostic evaluation tool system improves the diagnosis and management of acromegaly