[Long term treatment with growth hormone deficiency in adults]

Abstract

Background and objective: Deficiency of growth hormone (GH) in adult is accompanied by disorders that can resolve with its administration. The aim of the study is to assess clinical, biochemical and HR-QoL (Nottingham Health Profile and Qol AGHDA test) response to GH replacement at long term; and to difference between childhood onset (Group A) and adult onset (Group B).

Patients and methods: This was a retrospective observational study of 17 patients with hypopituitarism and GH deficiency, treated in our center for at least 60 months with GH. We assessed changes in biochemical parameters, anthropometric and bone mineral density (BMD). HR-QoL was assessed using Nottingham Health Profile and Qol-AGHDA questionnaires, and they were analyzed separately in two groups, based on whether the diagnosis was made during childhood (Group A) or it was adult-onset (Group B).

Results: We observed a significant increase in fasting blood glucose at the first year, which was maintained at 5 years. BMD remained unmodified at the first year but increased after 5 years of treatment with GH. In the cluster analysis, results were similar. Regarding the assessment of HRQL, Group A presented no improvement in the Qol-AGHDA or evaluated areas of the NHP, but in group B a significant improvement at first year in the Qol-AGHDA and in area of energy and emotion in the NHP test that persisted at 5 years (p<0.05) were observed.

Conclusions: Replacement therapy with GH produces long-term beneficial effects on BMD and HRQL, with good long-term tolerance without remarkable side effects.