Koltowska-Häggström Maria, Mattsson Anders F, Monson John P, Kind Paul, Badia Xavier, Casanueva Felipe F, Busschbach Jan, Koppeschaar Hans P F, Johannsson Gudmundur
KIGS/KIMS/ACROSTUDY Medical Outcomes, Endocrine Care, Pfizer, Sollentuna, Sweden.
Eur J Endocrinol. 2006 Jul;155(1):109-19. doi: 10.1530/eje.1.02176.
To determine whether impaired quality of life (QoL) in adults with GH deficiency (GHD) is reversible with long-term GH therapy and whether the responses in QoL dimensions differ from each other.
QoL was measured by the Quality of Life-Assessment for Growth Hormone Deficiency in Adults (QoL-AGHDA) in general population samples in England & Wales, The Netherlands, Spain and Sweden (n = 892, 1038, 868 and 1682 respectively) and compared with corresponding patients' data from KIMS (Pfizer International Metabolic Database) (n = 758, 247, 197 and 484 respectively) for 4-6 years a follow-up. The subsets of patients from England and Wales, and Sweden with longitudinal data for 5 years' follow-up were also analysed. The change of the total QoL-AGHDA scores and responses within dimensions were evaluated. Subanalyses were performed to identify any specificity in response pattern for gender, age, disease-onset and aetiology.
Irrespective of the degree of impairment, overall QoL improved dramatically in the first 12 months, with steady progress thereafter towards the country-specific population mean. Problems with memory and tiredness were the most serious burden for untreated patients, followed by tenseness, self-confidence and problems with socialising. With treatment, these improved in the reverse order, normalising for the latter three.
Long-term GH replacement results in sustained improvements towards the normative country-specific values in overall QoL and in most impaired dimensions. The lasting improvement and almost identical pattern of response in each patient subgroup and independent of the level of QoL impairment support the hypothesis that GHD may cause these patients' psychological problems.
确定生长激素缺乏症（GHD）成人患者生活质量（QoL）受损情况能否通过长期生长激素治疗得到改善，以及生活质量各维度的改善情况是否存在差异。
在英格兰和威尔士、荷兰、西班牙及瑞典的普通人群样本中，采用成人生长激素缺乏症生活质量评估量表（QoL-AGHDA）测量生活质量（样本量分别为892、1038、868和1682），并与辉瑞国际代谢数据库（KIMS）中相应患者的数据（样本量分别为758、247、197和484）进行比较，随访4 - 6年。对来自英格兰和威尔士以及瑞典的有5年随访纵向数据的患者亚组也进行了分析。评估QoL-AGHDA总分及各维度的变化情况。进行亚组分析以确定性别、年龄、疾病发病时间和病因在反应模式上的任何特异性。
无论受损程度如何，总体生活质量在最初12个月内显著改善，此后朝着各国特定人群均值稳步提升。记忆问题和疲劳是未治疗患者最严重的负担，其次是紧张、自信心和社交问题。经过治疗，这些问题按相反顺序得到改善，后三项恢复正常。
长期生长激素替代治疗可使总体生活质量及大多数受损维度持续改善至各国特定的正常水平。每个患者亚组均持续改善且反应模式几乎相同，且与生活质量受损程度无关，这支持了生长激素缺乏症可能导致这些患者心理问题的假说。
