Growth hormone deficiency in adults:: effects of replacement therapy on body composition and health-related quality of life

BACKGROUND AND OBJECTIVE: Deficiency of growth hormone (GH) in the adult is accompanied by changes in the body composition and a diminished health-related quality of life (HR-QoL). The aim of the study was to assess the biochemical response to GH replacement therapy and its safety as well as the resulting body composition and HR-QoL. PATIENTS AND METHODS: One hundred sixty-five patients with hypopituitarism and GH deficiency were studied. A double-blind, randomized, placebo-controlled, 6-months study was first designed, then followed by a further 6-months period in which all patients received GH. The initial GH dose was 0.125 IU/Kg/week followed by 0.250 IU/Kg/week. The body composition was determined by bioelectric impedanciometry and the HR-QoL was evaluated by the Nottingham Health Profile (NHP) and the QoL-AGHDA questionnaire. RESULTS: A significant increase in fat-free mass was observed during treatment with GH, which was accompanied with a simultaneous decrease in fat mass. Total body water increased during GH treatment. Energy and emotional reaction areas evaluated by the NHP showed changes at 6 months; no changes were observed in the remaining dimensions. A progressive improvement was observed in the QoL-AGHDA score in the treated group but not in the placebo group. Adverse events mainly consisted of fluid retention which resolved upon decrease of the dose. CONCLUSIONS: GH treatment in GH-deficient adults is in general well tolerated and leads to beneficial effects on body composition and HR-QoL.