Beneficial effects of long‐term GH replacement therapy on quality of life in adults with GH deficiency

Wirén, Lena; Bengtsson, Bengt‐Åke; Johannsson, Gudmundur

doi:10.1046/j.1365-2265.1998.00462.x

Cited by 119 publications

(75 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, because it relates to the findings of GHD and hypogonadism in this study, GH replacement is known to improve QoL in patients with adult-onset GHD and helps reduce fat mass and improve exercise capacity. 51,52,54,55,[74][75][76][77][78][79][80] The benefits of testosterone therapy for men are clear and considered standard practice. 50,57,81 In addition, the high prevalence of MetS in retired football players is important because lifestyle changes may reverse some of these findings and improve the cardiovascular and metabolic disease risks that are associated with MetS.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Kelly

Chaloner

Evans

et al. 2014

Journal of Neurotrauma

View full text Add to dashboard Cite

Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) and pituitary and metabolic function in retired football players. Retirees 30-65 years of age, with one or more years of National Football League (NFL) play and poor quality of life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal and metabolic syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth hormone deficiency (GHD) was defined with a standard cut point of 3 ng/mL and with a more stringent body mass index (BMI)-adjusted cut point. Subjects with and without hormonal deficiency (HD) were compared in terms of QoL, International Index of Erectile Function (IIEF) scores, metabolic parameters, and football career data. Of 74 subjects, 6 were excluded because of significant non-football-related TBIs. Of the remaining 68 subjects (mean age, 47.3 -10.2 years; median NFL years, 5; median NFL concussions, 3; mean BMI, 33.8 -6.0), 28 (41.2%) were GHD using a peak GH cutoff of < 3 ng/mL. However, with a BMI-adjusted definition of GHD, 13 of 68 (19.1%) were GHD. Using this BMI-adjusted definition, overall HD was found in 16 (23.5%) subjects: 10 (14.7%) with isolated GHD; 3 (4.4%) with isolated hypogonadism; and 3 (4.4%) with both GHD and hypogonadism. Subjects with HD had lower mean scores on the IIEF survey ( p = 0.016) and trended toward lower scores on the SF-36 MCS ( p = 0.113). MetS was present in 50% of subjects, including 5 of 6 (83%) with hypogonadism, and 29 of 62 (46.8%) without hypogonadism ( p = 0.087). Age, BMI, median years in NFL, games played, number of concussions, and acknowledged use of performance-enhancing steroids were similar between HD and non-HD groups. In summary, in this cohort of retired NFL players with poor QoL, 23.5% had HD, including 19% with GHD (using a BMI-adjusted definition), 9% with hypogonadism, and 50% had MetS. Although the cause of HD is unclear, these results suggest that GHD and hypogonadism may contribute to poor QoL, erectile dysfunction, and MetS in this population. Further study of pituitary function is warranted in athletes sustaining repetitive mTBI.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Kelly

Chaloner

Evans

et al. 2014

Journal of Neurotrauma

View full text Add to dashboard Cite

show abstract

“…The most consistently observed complaints in untreated adult patients with GH deficiency (GHD) are related to energy levels, vitality, mental fatigue, emotional reactions, social isolation and anxiety (4)(5)(6)(7)(8). Additionally, reduced self-confidence, disturbed sex life (6), decreased physical mobility (4), dissatisfaction with body image (9), poor memory (10), reduced cognitive function and decreased mood (11), as well as attention deficits (12) have also been reported.…”

Section: Introductionmentioning

confidence: 99%

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

Kołtowska-Häggström¹,

Mattsson²,

Shalet³

2009

European Journal of Endocrinology

View full text Add to dashboard Cite

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.

show abstract

“…Consequently, their use has led to a large variation in results and their interpretation with respect to the effects of GHD and GH replacement therapy on QOL (8,9). However, large-scale studies have since demonstrated that patients with GHD have a lower level of perceived QOL compared with a normative population (10), and that QOL in adults with GHD can be improved during and after GH replacement therapy (11,12).…”

Section: Introductionmentioning

confidence: 99%

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

Herschbach¹,

Henrich²,

Strasburger³

et al. 2001

European Journal of Endocrinology

View full text Add to dashboard Cite

Background: Adults with growth hormone (GH) de®ciency (GHD) may experience physical and psychological disturbances, which can affect their quality of life (QOL). Objectives: To develop and validate a disease-speci®c module from the previously published QOL measure Questions on Life Satisfaction Modules (QLS M ): the QLS M -H that speci®cally addressed the needs of patients with hypopituitarism. A second aim was for the questionnaire to be applicable across different cultural backgrounds in order to evaluate the ef®cacy of therapy in large, international clinical trials, thus providing additional clinical endpoints for these studies. Design: A preliminary German language version of the QLS M -H was developed from 26 semistructured interviews of adults with GHD. The questionnaire was then independently translated into ®ve other languages and applied in open, non-controlled, multicentre, longitudinal studies to patient n 717 and normative populations n 2700X Methods: A revised, nine-item version of the questionnaire was developed, based on previously de®ned criteria, and was evaluated for reliability and validity. Sensitivity to detect changes after GH replacement was also assessed. Results: The 16 items of the preliminary questionnaire were reduced to nine items on the basis of the correlation of items/factors from initial patient interviews. Psychometric analysis revealed the reliability of the nine-item scale. The Cronbach's alpha scores ranged from 0.81 to 0.89 and the test± retest correlations ranged from 0.76 to 0.88, all of which indicate reliability over time. Mean scores increased signi®cantly during GH replacement therapy, with observed changes greater than those seen with the non-speci®c modules of the QLS M , indicating the sensitivity of the scale. Conclusions: The QLS M -H questionnaire is concise, easy to complete, and can be effectively applied across different cultural backgrounds. Psychometric evaluation of the questionnaire reveals that it is a valid, reliable and sensitive tool useful for assessing impaired life satisfaction in adult patients with GHD and also for monitoring the ef®cacy of GH therapy.

show abstract

Beneficial effects of long‐term GH replacement therapy on quality of life in adults with GH deficiency

Cited by 119 publications

References 19 publications

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

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

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

Contact Info

Product

Resources

About