Endocrine Abstracts (2002) 3 P183

Long term treatment of adult growth hormone deficiency does not normalise quality of life compared to control subjects: A need for a different strategy?

IA Malik, T Groves, M Wallymahmed, JPH Wilding & IA MacFarlane

Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UK.

Background: numerous studies using a variety of quality of life (QOL) measures have shown multiple impairments in adults with growth hormone deficiency (GHD) compared to control subjects. There have been few studies however of QOL in a treated GHD population compared with healthy controls.

Method: 120 adults with treated GHD ( >1 year) were given the following QOL questionnaires at annual review: SF36, Nottingham Health Profile, Disease Impact, Life Fulfilment and Satisfaction scales, Mental Fatigue Questionnaire (MFQ)and Self Esteem scale, Hospital Anxiety Depression scale, Energy Visual Analogue Scale (VAS) and Qol-AGHDA (assessment of GHD in adults). In addition 51 healthy control subjects from the local population agreed to complete the questionnaires.

Results: 57 patients returned questionnaires and 54 had complete data for analysis. The mean age was 41.9 plus/minus 2.0 years (19 males) in GHD patients compared to a mean age of 36.5 plus/minus 1.6 years (25 males) in controls. All had hypothalamic pituitary disease. Mean duration of growth hormone replacement was 37.4 plus/minus 3.9 months. The treated GHD population had highly significant impairments in all the QOL measurements compared to the controls. Energy VAS: GHD 5.2 plus/minus 0.4 centimetres vs Controls 6.9 plus/minus 0.3 centimetres (p=0.0009). Qol-AGHDA: GHD 10.0 plus/minus 1.0 vs Controls 4.7 plus/minus 0.7 (p<0.0001). SF36 physical functioning domain: GHD 67.0 plus/minus 3.9 vs Controls 94.0 plus/minus 1.4 (p<0.0001). MFQ: GHD 18.2 plus/minus 1.2 vs Controls 13.2 plus/minus 0.7 (p=0.0026).

Conclusions: This large population with treated GHD have significant impairments in QOL despite adequate replacement with GH and other pituitary hormones. Further strategies to improve QOL in these individuals should therefore be considered e.g. psychological support and treatments and physical treatments (exercise programs).

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