[Growth hormone deficiency in adults: effects of replacement therapy on body composition and health-related quality of life].

BACKGROUND AND

OBJECTIVE

Deficiency of growth hormone (GH) in the adult is accompanied by changes in the body composition and a diminished health-related quality of life (HR-QoL). The aim of the study was to assess the biochemical response to GH replacement therapy and its safety as well as the resulting body composition and HR-QoL.

PATIENTS AND

METHODS

One hundred sixty-five patients with hypopituitarism and GH deficiency were studied. A double-blind,randomized, placebo-controlled, 6-months study was first designed,then followed by a further 6-months period in which all patients received GH. The initial GH dose was 0.125 IU/Kg/week followed by 0.250 IU/Kg/week. The body composition was determined by bioelectric impedanciometry and the HR-QoL was evaluated by the Nottingham Health Profile (NHP) and the QoL-AGHDA questionnaire.

RESULTS

A significant increase in fat-free mass was observed during treatment with GH, which was accompanied with a simultaneous decrease in fat mass. Total body water increased during GH treatment. Energy and emotional reaction areas evaluated by the NHP showed changes at 6 months; no changes were observed in the remaining dimensions. A progressive improvement was observed in the QoL-AGHDA score in the treated group but not in the placebo group. Adverse events mainly consisted of fluid retention which resolved upon decrease of the dose.

CONCLUSIONS

GH treatment in GH-deficient adults is in general well tolerated and leads to beneficial effects on body composition and HR-QoL.