Quality of life in adults with growth hormone (GH) deficiency: response to treatment with recombinant human GH in a placebo-controlled 21-month trial

Abstract

We examined the effect of GH supplementation on the psychological capacity and sense of well-being in 36 patients with adult-onset GH deficiency (GHD). Recombinant human GH was given in a 21-month cross-over, double blind trial, and quality of life was assessed by using three self-rating questionnaires: the Hopkins Symptom Check List (HSCL), the Nottingham Health Profile (NHP), and the Psychological General Well-Being index. In addition, at the final examination the spouses completed a short questionnaire concerning their partner. Before treatment, the patients had lowered quality of life as determined by the HSCL and NHP inventories, and a correlation between the duration of GHD and the reported symptoms was observed. Upon treatment, the HSCL score was lower (better) after placebo administration (mean +/- SD, 84 +/- 21.3) than at baseline (89 +/- 18.9; P = NS) and fell to 80.2 +/- 18.5 (P < 0.001) when active drug was given. The subscales regarding anxiety, fearfulness, and cognition were the most sensitive. It was apparent that the effect determined after GH therapy in part was due to a placebo effect. With NHP, the dimensions of energy and emotions responded most to treatment. Further, the spouses observed their partners to be improved in several aspects of mood and behavior (P < 0.05 to P < 0.0001) when active drug was given. The data thus demonstrate that GH, which is known to have multiple somatic effects, produces an improvement in the quality of life of adults with GHD.

Utility of P300 auditory event related potential latency in detecting cognitive dysfunction in growth hormone (GH) deficient patients with Sheehan's syndrome and effects of GH replacement therapy

“…Burman et al (5) have documented the effects of GHD and GHRT on quality of life and on cognition by the use of self-rating tests (psychological parameters, including cognition, have been assessed by a subscale of the Hopkins Symptom Check List) and by a partner questionnaire which are not formal tests on cognition. When compared with healthy controls, more problems in cognitive function in patients with AO GHD (15 females and 21 males) have been reported.…”

“…In recent years much interest has been expressed, and effort expanded, about the possibility that cognitive function is related to insulin-like growth factor-I (IGF-I) and GH. Indeed, impaired cognitive function has been demonstrated in adults with childhood-onset GHD (CO GHD) (2) and in adult-onset GHD (AO GHD) (5). In addition, a few studies have demonstrated that GH replacement therapy (GHRT), in both adults with CO GHD and AO GHD, has beneficial effects on cognitive deficits (3,5).…”

“…Indeed, impaired cognitive function has been demonstrated in adults with childhood-onset GHD (CO GHD) (2) and in adult-onset GHD (AO GHD) (5). In addition, a few studies have demonstrated that GH replacement therapy (GHRT), in both adults with CO GHD and AO GHD, has beneficial effects on cognitive deficits (3,5). In all of these studies, neuropsychological tests (questionnaires) have been used to assess cognitive performance.…”

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

“…The largest clinical trials that reported improvement in QoL in patients who received GH were conducted by Mårdh et al (22) and Wallymahmed et al (nZ32) (7). In almost all of these studies, the benefits of GH were revealed by some, but not all instruments employed and/or were attributed to certain, but not all, dimensions measured; finally, they seemed to be heavily dependent on the degree of the initial impairment and were partly related to placebo effect.…”

Terapia de reposição hormonal no hipopituitarismo

“…Quando comparados com pacientes recebendo placebo, pacientes adultos usando GH relatam melhora no humor, na energia, no bem estar, na qualidade do sono e na qualidade de vida em geral (33). Existe melhora também na tolerância ao exercício, por incremento da massa e força muscular e por melhora da capacidade cardíaca em decorrência do aumento da fração de ejeção do ventrículo esquerdo, do débito cardíaco e da redução da resistência vascular periférica (27).…”