The effects of two doses of replacement growth hormone on the biochemical, body composition and psychological profiles of growth hormone-deficient adults

Carroll, PV; Littlewood, R; Weissberger, Andrew J.; Bogalho, Paula; McGauley, Gill; Sönksen, P. H.; Russell-Jones, DL

doi:10.1530/eje.0.1370146

Cited by 49 publications

(32 citation statements)

References 29 publications

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“…It is well documented that GHD has a negative impact on QoL in adults (8,30,31), and several studies have reported an improvement following GH treatment (32)(33)(34)(35); this has been reported to be paralleled by a reduction in healthcare consumption (34,35). The present data showed QoL to be equally impaired in the IGHD and the MPHD group at baseline; both groups responded favourably to 2 years of GH treatment.…”

Section: Discussionsupporting

confidence: 69%

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum – a KIMS analysis

Klose

Jonsson²,

Abs³

et al. 2009

European Journal of Endocrinology

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Objective: To describe baseline clinical presentation, treatment effects and evolution of isolated GH deficiency (IGHD) to multiple pituitary hormone deficiency (MPHD) in adult-onset (AO) GHD. Design: Observational prospective study. Methods: Baseline characteristics were recorded in 4110 patients with organic AO-GHD, who were GH naïve prior to entry into the Pfizer International Metabolic Database (KIMS; 283 (7%) IGHD, 3827 MPHD). The effect of GH replacement after 2 years was assessed in those with available follow-up data (133 IGHD, 2207 MPHD), and development of new deficiencies in those with available data on concomitant medication (165 IGHD, 3006 MPHD). Results: IGHD and MPHD patients had similar baseline clinical presentation, and both groups responded similarly to 2 years of GH therapy, with favourable changes in lipid profile and improved quality of life. New deficiencies were observed in 35% of IGHD patients, which was similar to MPHD patients with one additional deficit other than GH. New deficiencies most often presented within the first year but were observed up to 6 years after GH commencement. Conversion of IGHD into MPHD was not predicted by aetiology, baseline characteristics, surgery or radiotherapy, whereas in MPHD additional deficits were predicted by age (P!0.001) and pituitary disease duration (P!0.01). Conclusion: Both AO-IGHD and -MPHD patients have similar baseline clinical presentation and respond equally well to 2 years of GH replacement. Hypopituitarism in adults seems to be a dynamic condition where new deficiencies can appear years after the initial diagnosis, and careful endocrine follow-up of all hypopituitary patients, including those with IGHD, is warranted. European Journal of Endocrinology 161 S75-S83

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Section: Discussionsupporting

confidence: 69%

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum – a KIMS analysis

Klose

Jonsson²,

Abs³

et al. 2009

European Journal of Endocrinology

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“…Indeed, a placebo effect on QoL has been observed using the Symptom Checklist-90 (SCL-90), the Social Adjustment Scale (SAS) (Florkowski et al 1998), the NHP (Burman et al 1995, Verhelst et al 1997, and the PGWB (Carroll et al 1997). Double-blind, placebo-controlled protocols have been developed to overcome the placebo effect, but the overt physical changes resulting from GH therapy render a true 'double-blind' protocol virtually impossible (Mardh et al 1994).…”

Section: Placebo Effectmentioning

confidence: 99%

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

Hull

Harvey²

2003

Journal of Endocrinology

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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.

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“…One of the most important impairments from a patient's point of view is the decline in health-related quality of life (HRQoL). The HRQoL decay is perceived in the areas of energy, emotional reaction, social behaviour, general health, self-control, anxiety, vitality, mood and sense of well-being measured by Nottingham Health Profile and the Psychological General Well-Being Schedule (2). Most studies showed a benefit of GH replacement on HRQoL (1).…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania

Moock

Albrecht²,

Friedrich³

et al. 2009

European Journal of Endocrinology

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Objective: To analyse 12-month response to GH treatment in a single-country cohort of hypopituitary adult patients with GH deficiency (GHD) in regards to health-related quality of life (HRQoL) and insulin-like growth factor-1 (IGF-1) compared with values from general population sample. Moreover, association between the response in HRQoL and the IGF-1 values in patients and in the background population was investigated. Design: HRQoL was assessed by quality of life assessment of GH deficiency in adults (QoL-AGHDA) in 651 patients retrieved from the German KIMS (Pfizer International Metabolic Database) before and after 12 months of GH replacement and in a sample drawn from a cross-sectional study in Germany (nZ2734). IGF-1 was measured in KIMS patients and in the population-based study with the same assay technique. Results: In KIMS patients, mean QoL-AGHDA scores before GH replacement were 9.2G6.8 (8.7G6.8) in women (men) and in the general population sample 4.5G5.3 (4.3G5.0) in women (men). Mean differences in QoL-AGHDA scores were statistically significant for all age categories (P!0.05). The mean IGF-1 SDS of KIMS patients before GH replacement was K1.1G1.4 (K0.8G1.4) in women (men). After GH replacement, a significant increase of IGF-1 concentration and a significant decrease of QoL-AGHDA scores near to age-and gender-specific population-based values were observed. Conclusions: This study confirms an improvement in HRQoL and an increase of IGF-1 SDS in GH-replaced adults, which approximated the values of general population. However, there was no association between IGF-1 values and HRQoL assessment as one of the important treatment outcomes.

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The effects of two doses of replacement growth hormone on the biochemical, body composition and psychological profiles of growth hormone-deficient adults

Abstract: This study examined the effects of growth hormone (GH) replacement on the insulin-like growth factor

Cited by 49 publications

References 29 publications

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum – a KIMS analysis

From isolated GH deficiency to multiple pituitary hormone deficiency: an evolving continuum – a KIMS analysis

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

Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania

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