Decreased psychological well‐being in adult patients with growth hormone deficiency

Rosén, Thord; Wirén, Lena; Wilhelmsen, Lars; Wiklund, Ingela; Bengtsson, Bengt‐Åke

doi:10.1111/j.1365-2265.1994.tb02452.x

Cited by 293 publications

(162 citation statements)

References 22 publications

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“…6.9 P!0.01), while the opposite was true for women (10.6 S.D. 6.3 in craniopharyngioma versus 13.4 S.D. 7.3 in NFPA P!0.01).…”

Section: Impact Of Demographic and Clinical Characteristicsmentioning

confidence: 83%

“…6.83 vs 11.3 S.D. 6.93 respectively P!0.05). The latter study observed gender-specific differences in QoL, namely male patients with craniopharyngioma experienced worse QoL (11.6 S.D.…”

Section: Impact Of Demographic and Clinical Characteristicsmentioning

confidence: 96%

“…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. A higher incidence of mental disorders, more pronouncedly expressed mental distress and relatively frequent cognitive dysfunctions complete this picture (13).…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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“…6.9 P!0.01), while the opposite was true for women (10.6 S.D. 6.3 in craniopharyngioma versus 13.4 S.D. 7.3 in NFPA P!0.01).…”

Section: Impact Of Demographic and Clinical Characteristicsmentioning

confidence: 83%

“…6.83 vs 11.3 S.D. 6.93 respectively P!0.05). The latter study observed gender-specific differences in QoL, namely male patients with craniopharyngioma experienced worse QoL (11.6 S.D.…”

Section: Impact Of Demographic and Clinical Characteristicsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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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

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“…Young GHD patients suffer from sleep disturbances and are psychologically immature (3). Untreated adult GHD patients exhibit general fatigue, lack of concentration, memory disabilities, and overall, a diminished subjective well being (4)(5)(6). Treatment of adult GHD patients with recombinant human GH is reported to induce increased psychological well being (1,2,5,7,8) and to improve cognitive efficiency and memory function (7)(8)(9).…”

mentioning

confidence: 99%

Growth hormone induces age-dependent alteration in the expression of hippocampal growth hormone receptor and N -methyl- d -aspartate receptor subunits gene transcripts in male rats

Grevès

Steensland²,

Grevès³

et al. 2002

Proc. Natl. Acad. Sci. U.S.A.

111

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Studies were conducted to evaluate the effects of s.c. injected recombinant human growth hormone (GH) on the expression of the gene transcript of N-methyl-D-aspartate receptor subunits type 1 (NR1), type 2A (NR2A), and type 2B (NR2B) in the male rat hippocampus. The GH-induced effects on the expression of hippocampal gene transcripts of GH receptor (GHR) and GH-binding protein were also examined. Male Sprague-Dawley rats, kept in four groups of two different ages, was treated with the hormone or saline during 10 days before decapitation and tissue dissection. Brain tissues collected were analyzed for mRNA content by using the Northern blot technique. The results indicated that in adult young rats (11 weeks of age) the hormone elicited a decrease in the mRNA expression of NR1 but an increase in that of the NR2B subunit. In elderly adult rats (57-67 weeks of age) GH induced an increase in the expression of the hippocampal message for NR1 and NR2A. Meanwhile, the hormone induced a significant up-regulation of the GHR transcript in hippocampus of adult young rats but not in elderly adult rats. It was further found that a significant positive correlation exists between the level of GHR mRNA and the expression of the NR2B subunit transcript in adult young rats. The GH-induced increase in the expression of hippocampal mRNA for the NR2B subunit is compatible with a previously observed memory promoting effect seen for the hormone, because overexpression of this N-methyl-D-aspartate receptor subunit is shown to enhance cognitive capabilities.

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“…Estudos em pacientes com deficiência de GH demonstram alteração na qualidade de vida, especialmente nas áreas de energia, isolamento social, distúrbio emocional e vida sexual, sendo sugerido que mudanças na qualidade de vida podem servir para monitorização da terapia de reposição com GH (71,72). Apesar de não termos avaliação objetiva da qualidade de vida, subjetivamente houve grande melhora, relatada inclusive por familiares.…”

Section: Deficiência De Gh Em Adultos: Estudo Brasileirounclassified

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

Conceição

Boguszewski

Meister

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOAvaliamos 70 pacientes com deficiência de GH, 39 mulheres e 31 homens, com idades entre 18 e 69 anos (média de 38,3±13,5), provenientes de 3 centros no Brasil. A dose de reposição variou entre os centros, bem como a resposta do IGF-1, que mostrou maior aumento nos centros com maior dose de GH. Reposição de GH levou a um aumento significativo nos níveis de IGF-1 e HDL colesterol, bem como da densidade mineral óssea (DMO), e a uma redução significativa nos níveis de colesterol total e LDL colesterol, semelhante nos 3 centros. Encontramos aumento mais significativo de HDL colesterol nas mulheres e aumento mais acentuado da DMO nos pacientes do sexo masculino. Concluimos que reposição de GH leva à melhora do perfil lipídico e da DMO, e que doses menores apresentam o mesmo benefício, provavelmente com menor incidência de efeitos colaterais. ABSTRACT GH Deficiency in Adults: Results of the Brazilian Multicenter Study.We have evaluated 70 patients with GH deficiency, 39 females and 31 males, ranging in age from 18 to 69 years (mean: 38.3±13.5), from 3 centers in Brazil. GH replacement dose was different among the centers, as well as IGF-1 response to GH, which was more pronounced in patients using the highest GH dose. GH replacement led to a significant increase of IGF-1 and HDL cholesterol, as well as bone mineral density (BMD) and to a significant decrease in total and LDL cholesterol that was similar among the centers. Female patients showed a more significant increase of HDL cholesterol, while men showed a more significant increase of BMD. In conclusion, GH replacement led to an improvement of lipid profile and BMD. Lower GH dose may lead to the same benefits, probably with a lower incidence of side effects.

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Decreased psychological well‐being in adult patients with growth hormone deficiency

Abstract: Adult patients with GH deficiency have a decreased psychological well-being in terms of energy, social isolation and emotional reaction and a disturbed sex life compared with normals. Furthermore, there is a tendency to a higher frequency of early retirement.

Cited by 293 publications

References 22 publications

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

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

Growth hormone induces age-dependent alteration in the expression of hippocampal growth hormone receptor and N -methyl- d -aspartate receptor subunits gene transcripts in male rats

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

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