Skip to main content
Log in

Long-term follow-up results of growth hormone therapy for patients with adult growth hormone deficiency

  • Research paper
  • Published:
Hormones Aims and scope Submit manuscript

Abstract

OBJECTIVE: We evaluated the long-term effects of growth hormone (GH) on markers of quality of life, glucose metabolism, and lipid metabolism to validate the adequacy of long-term GH replacement therapy for adult GH deficiency (AGHD). DESIGN: Eighty-three of 100 sequentially followed patients who received GH therapy were selected for this study. Forty-nine were men aged 26 to 78 years (mean, 52 years) and 34 were women aged 20 to 78 years (mean, 56 years). The GH-releasing peptide-2 stimulation test and arginine stimulation test were used to diagnose AGHD. The adult hypopituitarism questionnaire (AHQ) and biochemical parameters such as cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, and gyrated hemoglobin (HbA1c) were determined before treatment, at 6 months of treatment, and at 1, 2, 3, 4, 5, 6, 7, and 8 years of treatment. Considering age and sex as factors potentially influencing the effect of GH therapy, the patients were divided into age groups of <60 and ≥60 years and sex groups of men and women. Repeated measured analysis of variance (ANOVA) was employed. RESULTS: ANOVA demonstrated significant changes in mean AHQ scores during follow-up. Comparison of individual AHQ scores with baseline values revealed sequential improvements, stabilization, and decline in QOL. A significant elevation in HbA1c level was demonstrated. LDL-C and HDL-C levels changed significantly upon GH treatment regardless of sex or age. Levels of glucose, TC or TG did not change significantly. CONCLUSION: The effect of GH therapy on QOL showed sequential improvements and stabilization until 6-year follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gaillard RC, Mattsson AF, Akerblad AC, et al, 2012 Overall and cause-specific mortality in GH-deficient adults on GH replacement. Eur J Endocrinol 166: 1069–1077.

    Article  PubMed  CAS  Google Scholar 

  2. Prodam F, Caputo M, Beicastro S, et al, 2012 Quality of life, mood disturbances and psychological parameters in adult patients with GH deficiency. Panminerva Med 54: 323–331.

    PubMed  CAS  Google Scholar 

  3. Lobie PE, Zhu T, Graichen R, Goh LK, 2000 Growth hormone, IGF-1 and the CNS: localization, function and mechanism of action. Growth Horm IGF Res 10: Suppl B: 51–56.

    Article  CAS  Google Scholar 

  4. Isgaard J, Aberg D, Nilsson M, 2007 Protective and regenerative effects of the GH/IGF-1 axis on the brain. Minerva Endocrinol 32: 103–113.

    PubMed  CAS  Google Scholar 

  5. Aberg, ND, Brywe KG, Isgaard J, 2006 Aspects of GH and insulin-like growth factor-1 related to neuroprotection, regeneration, and functional plasticity in the adult brain. Sientific World Journal 6: 53–80.

    Article  CAS  Google Scholar 

  6. Florakis D, Hung V, Kaltsas G, et al, 2000 Sustained reduction in circulating cholesterol in adult hypopituitary patients given low dose titrated growth hormone replacement therapy; a two year study. Clin Endocrinol 53: 453–459.

    Article  CAS  Google Scholar 

  7. Bunderen CC, Nieuwpoort C, Arwert LI, et al, 2011 Dose growth hormone replacement therapy reduce mortality in adults with GHD? Data from the Dutch national registry of GH treatment in Adults. JCEM 96: 3151–3159.

    PubMed  Google Scholar 

  8. Claessen KM, Appelman-Dijkstra, Adoptie DMM, et al, 2013 Metabolic profile in GHD adults after long-term recombinant Human GD therapy. JCEM 91: 352–361.

    Google Scholar 

  9. Hitoshi Ishii, Akira Shimatsu, Yasuhiko Okimura, et al, 2012 Development and validation of a new questionnaire assessing quality of life in adults with hypopituitarism: adult hypopituitarism questionnaire (AHQ) PLoS One. 7: e44304.

    Article  CAS  Google Scholar 

  10. Jorgensen JOL, Christiansen JS 2005 Growth Hormone Deficiency in Adults. In Grossman AB, (ed) Frontiers of Hormone Research, Baser, Karger; pp, 209–221.

    Google Scholar 

  11. Wilton P, Koppeschaar HPF 2000 Safety of growth hormone replacement in adukts. In Monson JP, Bengtsson BA (eds), GH replacement in Adults-The First 5 years of KIMS. Oxford, OxfordPhrma Genesis.

    Google Scholar 

  12. Appelman-Dijkstra N, Claessen KM, Roelfsema F, Pereira A, Biermasz NR, 2013 Therapy of endocrine disease; Long-term effects of recombinant human GH replacement in adults with GH deficiency; a systematic review. Eur J endocrinol 169: R1–R14.

    Article  PubMed  CAS  Google Scholar 

  13. Svensson J, Mattsson A, Rosen T, et al, 2004 Three-years of growth hormone replacement therapy in GH-deficient adults: effects on quality of life, patient-reported outcomes and healthcare consumption. Growth Horm IGF Res 14: 207–215.

    Article  PubMed  CAS  Google Scholar 

  14. Holdaway IM, Manning HP, Cutfields W, et al, 2015 Three-year experience with access to nationally funded growth hormone (GH) replacement for GH-deficient adults. Clin Endocrinol 83: 85–90.

    Article  CAS  Google Scholar 

  15. Wiren L, Bengtsson BA, Johannsson G, 1988 Beneficial effects of long-term GH replacement therapy on quality of life in adults with GH deficiency. Clin Endocrinol 48: 613–620.

    Article  Google Scholar 

  16. Jorgensen AP, Fougner KJ, Ueland T, et al, 2011 Favorable long-term effect of growth hormone replacement therapy on quality of life, bone metabolism, body composition and lipid lebels in patients with adult-onset GH deficiency. Growth Horm IGF Res 21: 69–75.

    Article  PubMed  CAS  Google Scholar 

  17. Mo D, Blum WF, Rosilio M, Webb SM, Qi R, Strasburger CJ, 2014 Ten-year change in quality of life in adults on growth hormone replacement for GH deficiency: an analysis of the hypopituitary control and complication study. J Clin Endocrinol Metab 99: 4581–4588.

    Article  PubMed  CAS  Google Scholar 

  18. Cutfield WS, Wilton P, Bennmarker H, et al, 2000 Incidence of diabetes mellitus and impared glucose tolerance in children and adolescents receiving GH treatment. Lancet 355: 610–613.

    Article  PubMed  CAS  Google Scholar 

  19. Svensson J, Fowelin J, Landin K, Bengtsson BA, Johansson J, 2002 Effects of seven years of GH-replacement therapy on insulin sensitivity in GH-deficient adults. JCEM 7: 2121–2127.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hidetoshi Ikeda.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ikeda, H., Kudo, M. Long-term follow-up results of growth hormone therapy for patients with adult growth hormone deficiency. Hormones 15, 45–53 (2016). https://doi.org/10.1007/BF03401402

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03401402

Key words

Navigation