We studied 84 patients with neuropsychological disabilities at least 1 year after TBI. 24 patients had severe GHD (29%). The aim of this study was to evaluate the effects of six months GH treatment on quality of life and metabolism in this group.
GH treatment was initiated in 17 patients (71%), planned with 3, declined by one, contra-indicated in 2, 1 patient moved. It lasted more 6 months in 16 of them (14 men, mean age 36±12, mean delay after TBI 75±4, >36 months for 15 patients). GHD was isolated (n=6) or associated with ACTH deficiency (n=9) and/or TSH deficiency (n=3). GH treatment was initiated after the susbstitution of other deficiencies, at 0.3 mg/day. Dosage was increased in 25%, decreased in 25%. We suspected a defect of observance in 4 patients.The mean dosage at 6 months was 0.3 mg/d (0.2-0.4). IGF1 levels significantly increased (301.9±101.9 vs 190.4±65.4 ng/ml, P<0.001) and were normal in 94% of patients.
Before GH treatment, QoL-AGHDA questionnaire score was not different in patients with severe or no GHD (13.4±7.2 vs14.5±6.8). However we observed after GH treatment a significant decrease of QoL-AGHDA questionnaire score (9.7±7.8 vs 14.4±7.4, P<0.001), demonstrating an improvement of the quality of life.
Waist circumference (97±15.6 vs 98.9±16.4 cm), BMI (26.9±5.5 vs 27.7±5.6 kg/m2), fasting glucose (0.84±0.08 vs 0.87±0.11 g/l), triglyderid level (1.14±0.42 vs 1.21±0.37 g/l), LDLc level (1.08±0.21 vs 1.10±0.25 g/l) and HDLc level (0.44±0.08 vs 0.46±0.07 g/l) had not significantly changed after GH treatment.
These results illustrate that it is important to diagnose GHD in patients with previous TBI, because of its high frequency and the positive effect of GH treatment on the quality of life, even in this group. Results after 1 year GH treatment including the dual-energy X-ray absorptiometry will be presented for the congress.
03 - 07 May 2008
European Society of Endocrinology