title: GH deficiency after traumatic brain injury: improvement in quality of life with GH therapy: analysis of the KIMS database.
abstract: OBJECTIVE
  Prevalence of GH deficiency (GHD) caused by traumatic brain injury (TBI) is highly variable. Short-term studies show improvement in quality of life (QoL) during GH replacement (GHR), but long-term data are lacking. The aim of this study was to analyse the clinical characteristics of post-traumatic hypopituitarism and the QoL effects of long-term GHR.
  
  
  METHODS
  Pfizer International Metabolic Database patients with GHD caused by TBI and by non-functioning pituitary adenoma (NFPA) were compared regarding: clinical characteristics at baseline and 1-year of GHR, and QoL response up to 8-years of GHR (QoL-AGHDA total scores and dimensions) in relationship with country-specific norms.
  
  
  RESULTS
  TBI patients compared with NFPA patients were younger, diagnosed with GHD 2.4 years later after primary disease onset (P<0.0001), had a higher incidence of isolated GHD, higher GH peak, a more favourable metabolic profile and worse QoL, were shorter by 0.9 cm (1.8 cm when corrected for age and gender; P=0.004) and received higher GH dose (mean difference: 0.04 mg/day P=0.006). In TBI patients, 1-year improvement in QoL was greater than in NFPA (change in QoL-AGHDA score 5.0 vs 3.5, respectively, P=0.04) and was sustained over 8 years. In TBI patients, socialisation normalised after 1 year of GHR, self-confidence and tenseness after 6 years and no normalisation of tiredness and memory was observed.
  
  
  CONCLUSIONS
  Compared with NFPA, TBI patients presented biochemically with less severe hypopituitarism and worse QoL scores. GHR achieved clinically relevant, long-term benefit in QoL.
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Gardner
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden.
authors.forename: Anders F
authors.initials: AF
authors.lastname: Mattsson
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Daousi
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden.
authors.forename: Márta
authors.initials: M
authors.lastname: Korbonits
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Koltowska-Haggstrom
authors.affiliation: Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden daniel.cuthbertson@liverpool.ac.uk.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cuthbertson
mesh_terms: D000236:Adenoma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D016208:Databases, Factual; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life
chemical_list: D019382:Human Growth Hormone