title: Body composition and quality of life in adults treated with GH therapy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To summarise the evidence about the efficacy and safety of using GH in adults with GH deficiency focusing on quality of life and body composition.
  
  
  METHODS
  We searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science and Scopus through April 2011. We also reviewed reference lists and contacted experts to identify candidate studies.
  
  
  METHODS
  Reviewers, working independently and in duplicate, selected randomised controlled trials (RCTs) that compared GH to placebo.
  
  
  RESULTS
  We pooled the relative risk (RR) and weighted mean difference (WMD) by the random effects model and assessed heterogeneity using the I(2) statistic.
  
  
  RESULTS
  Fifty-four RCTs were included enrolling over 3400 patients. The quality of the included trials was fair. GH use was associated with statistically significant reduction in weight (WMD, 95% confidence interval (95% CI): -2.31 kg, -2.66 and -1.96) and body fat content (WMD, 95% CI: -2.56 kg, -2.97 and -2.16); increase in lean body mass (WMD, 95% CI: 1.38, 1.10 and 1.65), the risk of oedema (RR, 95% CI: 6.07, 4.34 and 8.48) and joint stiffness (RR, 95% CI: 4.17, 1.4 and 12.38); without significant changes in body mass index, bone mineral density or other adverse effects. Quality of life measures improved in 11 of the 16 trials although meta-analysis was not feasible.
  
  
  RESULTS
  GH therapy in adults with confirmed GH deficiency reduces weight and body fat, increases lean body mass and increases oedema and joint stiffness. Most trials demonstrated improvement in quality of life measures.
authors.affiliation: Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hazem
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Elamin
authors.forename: Irina
authors.initials: I
authors.lastname: Bancos
authors.forename: German
authors.initials: G
authors.lastname: Malaga
authors.forename: Gabriela
authors.initials: G
authors.lastname: Prutsky
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Domecq
authors.forename: Tarig A
authors.initials: TA
authors.lastname: Elraiyah
authors.forename: Nisrin O
authors.initials: NO
authors.lastname: Abu Elnour
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Prevost
authors.forename: Jaime P
authors.initials: JP
authors.lastname: Almandoz
authors.forename: Claudia
authors.initials: C
authors.lastname: Zeballos-Palacios
authors.forename: Edgar R
authors.initials: ER
authors.lastname: Velasquez
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.forename: Neena
authors.initials: N
authors.lastname: Natt
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D002986:Clinical Trials as Topic; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010900:Pituitary Diseases / Q000188:drug therapy; D011788:Quality of Life
chemical_list: D013006:Growth Hormone