Effect of growth hormone replacement therapy on the quality of life in women with growth hormone deficiency who have a history of acromegaly versus other disorders

Abstract

Objective: To compare the response in quality of life (QoL) to growth hormone (GH) replacement in women with GH deficiency (GHD) and a history of acromegaly with that in women with GHD of other causes.

Methods: Fifty-five women with GHD were studied: 17 with prior acromegaly and 38 with other causes of GHD. We compared two 6-month, randomized, placebo-controlled studies of GH therapy in women with hypopituitarism conducted with use of the same design-one in women with a history of acromegaly and one in women with no prior acromegaly. QoL was assessed with the following questionnaires: the QoL-Assessment of Growth Hormone Deficiency in Adults (AGHDA), the Symptom Questionnaire, and the 36-Item Short-Form Health Survey (SF-36).

Results: The 2 groups had comparable mean pretreatment age, body mass index, and QoL scores and comparable mean GH dose at 6 months (0.61 ± 0.30 versus 0.67 ± 0.27 mg daily). After 6 months of GH replacement therapy, women with GHD and prior acromegaly demonstrated a greater improvement in AGHDA score, four SF-36 sub-scales (Role Limitations due to Physical Health, Energy or Fatigue, Emotional Well-Being, and Social Functioning), and the Somatic Symptoms subscale of the Symptom Questionnaire than did women with GHD of other causes. Poorer pretreatment QoL was associated with a greater improvement in QoL after administration of GH.

Conclusion: In this study, GH replacement therapy improved QoL in women with GHD and a history of acromegaly but not in women with GHD due to other hypothalamic and pituitary disorders. Further studies are needed to determine the long-term risks versus benefits of GH replacement in patients who develop GHD after definitive treatment for acromegaly.

Fig. 1

Mean (± standard error of the mean) pretreatment and 6-month insulinlike growth factor-I (IGF-I) standard deviation score (SDS) values. *P<.05.

Fig. 2

Mean (± standard error of the mean) change during a 6-month period in quality of life (QoL) as assessed by the QoL-Assessment of Growth Hormone Deficiency in Adults (AGHDA) (panel A), 36-Item Short-Form Health Survey (SF-36) (panel B), and Symptom Questionnaire (panel C). Higher scores are indicative of a more impaired QoL on the QoL-AGHDA and Symptom Questionnaire and a better QoL on the SF-36. *P<.05. Subscales on the SF-36: BP = Bodily Pain; E/F = Energy or Fatigue; EWB = Emotional Weil-Being; Gen H = General Health Perception; PF = Physical Functioning; RLEH = Role Limitations due to Emotional Health; RLPH = Role Limitations due to Physical Health; SF = Social Functioning.