The "quality of life-assessment of growth hormone deficiency in adults" questionnaire: can it be used to assess quality of life in hypopituitarism?

Patients with hypopituitarism often have a multitude of physical and psychological complaints, collectively referred to as low quality of life (QoL). It has been asserted that GH deficiency (GHD) is the causative factor, and improved QoL scores have been reported during GH replacement. Qol-assessment of GHD (QoL-AGHDA) is the newest psychometric instrument with the purportedly high specificity for the issues encountered by patients with GHD. QoL-AGHDA was administered to 30 normal control subjects, 20 patients with severe GHD, and 22 patients with active acromegaly. QoL-AGHDA scores in controls (3.3 +/- 0.7) were significantly (P < 0.001) different from those in patients with hypopituitarism with unsubstituted GHD (10.6 +/- 1.5) and active acromegaly (11.6 +/- 1.6). However, QoL-AGHDA was unable to discriminate between the latter two groups, one with GHD and the other with GH excess. We conclude that as QoL-AGHDA cannot distinguish between the extremes of GH output, its ability to detect an improvement in QoL during GH replacement has to be viewed with skepticism. This can be dispelled only by double blind, placebo-controlled studies.