Effects of GH on cognitive function in elderly patients with adult-onset GH deficiency: a placebo-controlled 12-month study

The GH/IGF1 axis may play an important role in cognitive function. This theory is supported by the finding that both GH and IGF1 receptors are located in several brain areas such as the hippocampus, a brain area that is known to play an essential role in cognitive processes, especially memory and learning. However, the exact mechanism by which the GH/IGF1 axis influences the cognitive functions is still unknown. Furthermore, little is known about the cognition in adults with both childhood-onset and adult-onset GH deficiency (CO-GHD and AO-GHD). Recent data indicate that cognitive function, particularly attention and memory, in adults with GHD might be impaired. To date, only a limited number of studies have been conducted to study the effects of GH replacement therapy on cognitive function in adults with GHD. In this paper, the results of studies on cognitive functioning in GHD patients, in particular the results of the studies performed in adults with CO-GHD, and the effects of GH replacement therapy in these patients, will be discussed. European Journal of Endocrinology 159 S53-S57

Section: Cognition In Adults With Ao-ghdmentioning

confidence: 75%

Cognition in the adult with childhood-onset GH deficiency

Nieuwpoort

Drent

2008

“…In almost all of these studies, the benefits of GH were revealed by some, but not all instruments employed and/or were attributed to certain, but not all, dimensions measured; finally, they seemed to be heavily dependent on the degree of the initial impairment and were partly related to placebo effect. On the other hand, in the studies by Cuneo et (26) no change in QoL in the treated patients was found.…”

Section: Introductionmentioning

confidence: 79%

Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

Kołtowska-Häggström¹,

Mattsson²,

Shalet³

2009

Quality of life (QoL) has emerged as an important construct that has found numerous applications across healthcare-related fields, ranging from research and clinical evaluation of treatment effects to pharmacoeconomic evaluations and global healthcare policy. Impairment of QoL is one of the key clinical characteristics in adult GHD and has been extensively studied in the Pfizer International Metabolic Database (KIMS). We provide summarized evidence on GH treatment effects for both clinical and health economic applications based on the KIMS data. The primary focus is on those aspects of QoL research that cannot be investigated in the traditional clinical trial setting, such as specific patient subgroups, cross-country comparisons and long-term follow-up. First, the impact of age, gender, disease onset, primary aetiology, extent of hypopituitarism, previous radiotherapy and obesity on QoL before and during long-term GH replacement is discussed. Secondly, the studies on QoL in relation to country-specific normative values are reviewed. Finally, health economic data derived from KIMS including both burden of disease and utility assessment are evaluated. We conclude that the wide spectrum of analyses performed on the KIMS data allows for practical application of the results not only to research and clinical practice but also to health policy and global medical decision making.

“…In addition, the higher tendency of IGF1/GH ratios in the elderly group than others was found in female but not male patients. In patients with GH deficiency, it has been reported that the gender difference remains in elderly patients, i.e., women above 60 years have lower IGF1 than men, in spite of similar GH secretion (12). Therefore, it is interesting to note the relatively higher IGF1 levels in elderly female patients with acromegaly.…”

Section: Young (%30 Years)mentioning

confidence: 94%

The influence of age on the GH–IGF1 axis in patients with acromegaly

Tanimoto

Hizuka

Izumi³

et al. 2008

Objective: The purpose of this study was to investigate the influence of age on GH and IGF1 axis, and complications in patients with acromegaly. Subjects and methods: From the medical records, we retrospectively analyzed clinical features and complications in 87 newly diagnosed patients with active acromegaly (34 males, 53 females; aged 18-82 years) who were admitted to Tokyo Women's Medical University between 1999 and 2006. We divided the patients into three groups according to age: %30 years old (young group), 31-60 years old (middle-aged group), and R61 years old (elderly group). Results: The median GH levels in young, middle-aged, and elderly groups were 18.5, 8.8, and 6.7 mg/l respectively, and the IGF1 levels were 810, 717, and 740 mg/l respectively. The values were not significantly different among the groups. However, the serum IGF1 SDS were significantly higher in the elderly group (10.2) than those in young and middle-aged groups (6.6 and 6.2 respectively, P!0.001). The age difference in the higher IGF1 SDS was remarkable in female patients. In the elderly group, glucose intolerance and hypertension were found in 94 and 53% of the patients respectively and the incidences were higher than those in the other groups. Conclusion: This study suggests that the relatively high IGF1 secretions in elderly patients might be involved in the progression of clinical complications in acromegalic patients. Therefore, awareness of the early symptoms and examination of serum GH and IGF1 are important for patients with acromegaly.