title: Ten-year change in quality of life in adults on growth hormone replacement for growth hormone deficiency: an analysis of the hypopituitary control and complications study.
abstract: BACKGROUND
  Previous studies showed improvement in impaired quality of life (QoL) in adult patients with growth hormone (GH) deficiency (GHD) who were treated with GH; improvement was sustained over a few years after GH therapy.
  
  
  OBJECTIVE
  To evaluate the QoL over 10 years.
  
  
  METHODS
  This was a prospective observational study.
  
  
  METHODS
  The study was conducted in clinical practice.
  
  
  METHODS
  1436 adult patients with adult-onset (AO) GHD (mean age [standard deviation (SD)]: 49.0 [12.2] years; 49% female) and 96 with childhood-onset (CO) GHD (31.3 [10.0] years; 60% female) (total N = 1532).
  
  
  METHODS
  GH therapy.
  
  
  METHODS
  QoL was measured by Questions on Life Satisfaction-Hypopituitarism (QLS-H) in countries where validated questionnaires and normative data for calculation of Z-scores were available. Change in QoL was tested by Student's t test and predicted by mixed-model repeated measures (MMRM) analysis.
  
  
  RESULTS
  At study entry, patients had diminished QoL Z-scores (mean [SD] AO, -1.55 [1.69]; CO -0.98 [1.32]). The largest QoL improvements were in the first year: mean (SD) increase 0.77 (1.37) for AO (P < .001) and 0.50 (1.37) for CO (P < .001). The initial improvement from study entry remained statistically significant throughout 10 years for AO and in years 1 to 4, 6, and 7 for CO (P < .05). MMRM analysis predicted a greater QoL improvement in those who were not depressed, lived in Europe, had poorer Z-scores at entry, had lower body mass index at entry, and had no impaired vision.
  
  
  CONCLUSIONS
  These data suggest that GH replacement provides sustained improvement in QLS-H scores toward normality for up to 10 years.
authors.affiliation: Lilly Diabetes (D.M., R.Q.), Eli Lilly and Company, Indianapolis, Indiana 46285; Lilly Diabetes (W.F.B.), Eli Lilly and Company, Bad Homburg 61352, Germany; Lilly France (M.R.), 92521 Neuilly sur Seine, France; Department of Endocrinology/Medicine and CIBERER 747 (S.M.W.), Hospital S Pau, Universitat Autonoma de Barcelona, 08193 Cerdanyola del Vallès, Barcelona, Spain; Department of Endocrinology (C.J.S.), and Diabetes and Nutritional Medicine, Charité-Universitätsmedizin, Campus Mitte, 13353 Berlin, Germany.
authors.forename: Daojun
authors.initials: D
authors.lastname: Mo
authors.forename: Werner F
authors.initials: WF
authors.lastname: Blum
authors.forename: Myriam
authors.initials: M
authors.lastname: Rosilio
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
authors.forename: Rong
authors.initials: R
authors.lastname: Qi
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Strasburger
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D013006:Growth Hormone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000523:psychology*; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D019382:Human Growth Hormone; D013006:Growth Hormone