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Quality of Life in Childhood Onset Growth Hormone-Deficient Patients in the Transition Phase from Childhood to Adulthood

Cascina del Rosone (A.F.A.), 14041 Agliano Terme, Italy; Pharma Support, Inc. (E.P.S.), 191119 St. Petersburg, Russia; Eli Lilly & Company (W.F.B.), 61350 Bad Homburg, Germany; and Christie Hospital (S.M.S.), Manchester M20 4BX, United Kingdom

Address all correspondence and requests for reprints to: Dr. Stephen M. Shalet, Department of Endocrinology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. E-mail: stephen.m.shalet{at}man.ac.uk.

Background: Quality of life (QoL) has not been specifically assessed in GH-deficient (GHD) transition patients.

Methods: We assessed QoL at baseline and after 1 and 2 yr of GH treatment in severely GHD patients, using an adult GHD-specific questionnaire, QLS^M-H. Subjects were randomized to GH, 25.0 µg/kg·d (n = 25) or 12.5 µg/kg·d (n = 28), or no treatment (n = 13). SD scores for QLS-H were calculated from normative data, specific to country of origin, gender, and age range of the patients.

Results: Baseline QLS-H SD scores were –0.35 ± 1.17 in females and –0.70 ± 1.05 in males (P = 0.280). SD scores for individual dimensions of ability to become sexually aroused, ability to tolerate stress, body shape, concentration, initiative/drive, physical stamina, and self-confidence were significantly lower than the normal average. Particularly affected were body shape (SD score, –0.80 ± 0.99; quartile (Q)1:Q3, –1.52:–0.29) and sexual arousal (SD score, –0.41 ± 0.88; Q1:Q3, –1.15:–0.13). Total QLS-H SD score increased slightly but not significantly for combined GH treatment groups compared with control at yr 1 (0.047 ± 1.51 vs. –0.32 ± 1.66; P = 0.845) but not after yr 2 (–0.00 ± 0.80 vs. 0.12 ± 0.89; P = 0.385); no dose effect of GH was observed. GH treatment significantly increased SD score from baseline to yr 2 for sexual arousal and body shape (0.23 ± 0.78, P = 0.038; and 0.46 ± 1.26, P = 0.035, respectively).

Conclusion: Although overall baseline QoL was not compromised in severely GHD patients during the transition period, dimensions related to age-specific psychological problems were significantly worse than healthy subjects and appeared to positively respond to GH treatment.

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