Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Abstract

The actions of growth hormone (GH) are not restricted to growth: GH modulates metabolic pathways as well as neural, reproductive, immune, cardiovascular, and pulmonary physiology. The importance of GH in most physiological systems suggests that GH deficiency at any age would be associated with significant morbidity. However, prior to the advent of recombinant GH, cadaverderived GH was only used therapeutically to correct the height deficit, and thereby hypothetically improve quality of life (QoL), in GH-deficient children. Physicians now have access to unlimited, albeit expensive, supplies of recombinant GH, and are considering the advisability of GH replacement or supplementation in other patient populations. This paper analyses studies investigating the relationship between GH and QoL in GH-deficient children or adults, in GH-replete short children suffering from idiopathic short stature, Turner syndrome, or intrauterine growth retardation and in GH-deficient or replete elderly adults. Possible mechanisms by which GH might improve QoL at neural and somatic sites are also proposed.

Heterogeneity in responsiveness of perceived quality of life to body composition changes between adult- and childhood-onset Japanese hypopituitary adults with GH deficiency during GH replacement

“…GH replacement therapy for adult patients was registered in Western countries more than a decade ago and its effects on QoL have been extensively studied in Caucasian patients. Results have not always been consistent, however, possibly due to methodological differences such as in the optimal dosing of GH, sensitivity of the QoL instrument to the specific psychosocial symptoms of GH deficient adults, and differences in the populations studied (2)(3)(4). In particular, the time of onset of GHD has been shown to be an important factor that influences the outcome of GHD and GH replacement.…”

Effect of KAATSU training on a patient with benign fasciculation syndrome

“…Exercise is the most effective therapy for sarcopenia and also greatly contributes to improve QOL of patients through such effects as preventing lifestyle-related diseases and delaying the onset of dementia. Aging has often been associated with hyposecretion of growth hormone (GH), and GH hyposecretion has been associated with muscle atrophy and depressive symptoms, thereby affecting patients QOL (Hull and Harvey, 2003). Although it is unclear how KAATSU exercise induces enhanced muscle strength and the mechanism of myopachynsis, it has been shown that a significant increase in GH level is observed immediately after KAATSU exercise (Takarada et al, 2000a;Takano et al, 2005;Abe et al, 2006).…”

The aging process and function of endocrine glands

“…A decrease in fatfree body mass, reduced fat mass, improved physical performance, mood, cognitive functions and memory were observed as a result of rhGH administration. However, the above mentioned therapy involves some adverse effects including peripheral oedemas, arterial hypertension, glucose intolerance and diabetes, arthralgia, acromegaly, and a risk of cancer [17,18]. Liu et al in a meta-analysis (covering 31 randomised studies) published in 2007, confirmed the advantages resulting from rhGH administration in the elderly, but also reported numerous therapy-associated adverse effects.…”

“…Terapia ta nie jest jednak pozbawiona działań ubocznych, którymi są m.in. obrzęki obwodowe, nadciśnienie tętnicze, nietolerancja glukozy i cukrzyca, bóle stawów, akromegalia, ryzyko pojawienia się choroby nowotworowej [17,18]. Liu i wsp.…”