title: Long-term improvement of quality of life during growth hormone (GH) replacement therapy in adults with GH deficiency, as measured by questions on life satisfaction-hypopituitarism (QLS-H).
abstract: Questions on Life Satisfaction-Hypopituitarism (QLS-H) is a new quality-of-life (QoL) questionnaire developed for adults with hypopituitarism. To determine the effects of long-term GH treatment on QoL, we evaluated QLS-H Z-scores in 576 adult patients with GH deficiency (GHD) enrolled in HypoCCS, an international observational study, using data from five countries in which comparative QLS-H data from the general population were available. Baseline QLS-H Z-scores were significantly lower in GH-deficient patients than in the general population of the same age, gender, and nationality. Z-scores were also significantly lower in female patients vs. males (P = 0.006) and in adult-onset vs. childhood-onset GHD (P = 0.002). Multivariate analysis associated female gender, multiple pituitary hormone deficiencies, low serum IGF-I values (<75 micro g/liter), and concomitant antidepressant medication with low baseline Z-scores. QLS-H Z-scores increased from -1.02 +/- 1.43 (SD) at baseline to -0.25 +/- 1.34 (SD) after 1 yr of GH treatment (P < 0.001) and were no longer significantly different from the general population after 4 yr of treatment. There was no correlation between change in Z-score and GH dose or changes in IGF-I and IGF binding protein-3 during treatment. This study demonstrates that 1) improvements in QoL, as measured by the QLS-H, are maintained during long-term GH replacement therapy of adults with GHD, and 2) the QLS-H is a useful tool for evaluating QoL in hypopituitary patients treated in clinical practice. The authors suggest that evaluation of QoL should be a part of the routine clinical management of adult GH-deficient patients, complementing the measurement of surrogate biological markers or other clinical end points.
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Co., Indianapolis, Indiana 46285, USA. rosilio_myriam@lilly.com
authors.forename: Myriam
authors.initials: M
authors.lastname: Rosilio
authors.forename: Werner F
authors.initials: WF
authors.lastname: Blum
authors.forename: David J
authors.initials: DJ
authors.lastname: Edwards
authors.forename: Elena P
authors.initials: EP
authors.lastname: Shavrikova
authors.forename: Domenico
authors.initials: D
authors.lastname: Valle
authors.forename: Steven W J
authors.initials: SW
authors.lastname: Lamberts
authors.forename: Eva Marie
authors.initials: EM
authors.lastname: Erfurth
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Ross
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chihara
authors.forename: Gerhard
authors.initials: G
authors.lastname: Henrich
authors.forename: Peter
authors.initials: P
authors.lastname: Herschbach
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Attanasio
mesh_terms: D000328:Adult; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008661:Metabolism, Inborn Errors / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D019382:Human Growth Hormone