Quality of life in childhood onset growth hormone-deficient patients in the transition phase from childhood to adulthood.

Abstract

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 microg/kg.d (n = 25) or 12.5 microg/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.