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.

Hypopituitarism due to sports related head trauma and the effects of growth hormone replacement in retired amateur boxers

“…Future clinical and mechanical studies are needed to understand the importance of headgear in protection of hypopituitarism due to sports related head trauma and to develop safer headgears. GH deficiency in adults is a well defined clinical entity and associated with abnormal body composition, decreased energy level, decreased exercise performance, impaired lipid profile, altered cardiac function and impaired quality of life including cognitive function [7,8]. After GHRT improvements in most of these parameters have been demonstrated in previous studies [7,9].…”

“…GH deficiency in adults is a well defined clinical entity and associated with abnormal body composition, decreased energy level, decreased exercise performance, impaired lipid profile, altered cardiac function and impaired quality of life including cognitive function [7,8]. After GHRT improvements in most of these parameters have been demonstrated in previous studies [7,9]. Retired amateur boxers with lower IGF-I, higher leptin levels, and increased abdominal fat ratio were shown to have increased risk for cardiovascular disorders than young boxers with normal IGF-I levels and normal body composition [10].…”

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

“…GH replacement therapy has improved psychological capabilities in young as well as adult GH-deficient (GHD) patients (1,2). 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). GH is also shown to affect learning processes and memory function in rats.…”

GH Deficiency as The Most Common Pituitary Defect After TBI: Clinical Implications

“…The syndrome consists of the variable presence of increased body fat and decreased lean body mass, decreased bone mass and incresed fracture rate,impired cardiac function and reduced muscle strength.GHD in adults shares a number of characteristics of the metabolic syndrome including hypertension, abdominal obesity, insulin resistance, dyslipidemia and enhanced thrombotic factors.In addition, quality of life is impaired, with reduction in physical and mental energy, increased anxiety, dissatisfaction with body image and poor memory [24][25][26]. There is evidence of increased cardiovascular mortality in hypopituitary patients without GH therapy [27].…”