Quality of Life Assessment Before and After Growth Hormone Treatment in Adults with Growth Hormone Deficiency

Abstract

Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency. Acta Paediatr Scand [Suppl] 356: 70, 1989. The effect of recombinant human growth hormone (rhGH) treatment on the quality of life w'as studied in adults with growth hormone deficiency (GHD). Twenty-four adults who satisfied strict criteria for GHD took part in a double-blind, placebo-controlled, 6-month trial. 'Quality of life' assessment was performed at entry into the trial and after 1 month and 6 months, by means of self-rating questionnaires. Entry data were also compared with a control group of healthy subjects matched for age, gender, ethnic origin, socio-economic class and area of residence. Significantly lower scores on 'quality of life' assessment in the growth hormone (GH) deficient patients were reported at entry into the trial compared with matched controls, indicating that patients with GHD may be psychologically compromised. Preliminary analysis of the results shows that after 6 months patients receiving human growth hormone (hGH) treatment experienced less perceived illness than the placebo group. Significant psychological improvement was noted in the hGH-treated patients' perception of their energy level and mood compared to the placebo group. Key words: Qua& of life, psychological well-being, growth hormone deficiency.The personality and social development of children with hypopituitary short stature due to impaired growth hormone (GH) secretion, and their psychological response to GH replacement therapy have been previously documented (1, 2). Children with GHD were found to be psychologically immature and showed a diffuse disturbance of personality formation. In their long-term follow-up studies of adults previously treated with hGH in childhood, Dean et al. and Job et al. measured the educational, marital and employment status in order to discuss social outcome and psychological integration (3, 4). Their results showed that patients with GHD were more likely to be single and unemployed.Little work has been published on the psychological status of GH deficient adults and the effect of hGH replacement therapy on their general well-being and quality of life. PATIENTS AND METHODSSubject selection and characteristics. Patients were selected for the study if they satisfied the following criteria: age between 18 and 55 years; GH deficient for at least 12 months; if pituitary hormone replacement had been required, the treatment regimen should have been stable for 12 months before entry into the study. GHD was defined as a GH concentration of < 3mUil during an insulin tolerance test, with a venous plasma glucose concentration of I 2.0 mmolil and/or associated with symptoms of hypoglycaemia. The mean known duration of GHD was 8 years. The majority of the patients acquired GHD in adulthood as a consequence of pituitary tumours and/or pituitary surgery. All patients were on pituitary replacement therapy. In addition, a group of control subjects for baseline comparison were matched for age, gend...

Interdependence of lean body mass and total body water, but not quality of life measures, during low dose GH replacement in GH-deficient adults

“…In particular, significant impairment in QOL is less frequently observed in adults with childhood-onset GHD (32). The areas of QOL most likely to be affected by GHD are energy and vitality (5). Moreover, the degree of improvement in QOL is proportional to the deviation from normality at the outset (6) and this observation is equally applicable to adults with childhood onset GHD (33) and unusual cohorts such as cancer survivors with GHD (34).…”

“…Impairment in quality of life (QOL) is a prominent feature of adult GHD (1). The areas of QOL most likely to be affected by GHD are energy and vitality (5) and the degree of improvement is proportional to the deviation from normality at the outset (6). However, the mechanisms underlying these observations remain poorly understood (6).…”

Development and psychometric properties of a disease-specific quality of life questionnaire for adult patients with growth hormone deficiency

“…Patients in the UK study had the lowest life satisfaction, with a value of 7.7, whereas Italians had the highest score, at 49. 4.…”

“…Furthermore, adults with GHD experience disturbances in their psychological wellbeing, including factors such as dissatisfaction with body image, low energy levels, emotional lability, mental fatigue and impaired psychosocial status (3,4). These factors can have a signi®cant impact on a patient's life satisfaction or quality of life (QOL).…”

Local overexpression of GH and GH/IGF1 effects in the adult mouse hippocampus

“…In humans, GH deficiency (GHD) is associated with an impaired quality of life (McGauley 1989, Bengtsson et al 1993, McGauley et al 1996, Burman & Deijen 1998, as well as poor memory and executive functions (Falleti et al 2006). GH treatment alleviates these conditions in humans and in experimental animals (Deijen et al 2005, Aberg et al 2006, Le Greves et al 2006, Molitch et al 2011.…”