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生长激素缺乏成年患者接受生长激素替代治疗时的健康相关生活质量与胰岛素样生长因子-1:德国KIMS数据及波美拉尼亚健康研究分析

Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania.

作者信息

Moock Joern, Albrecht Christin, Friedrich Nele, Völzke Henry, Nauck Matthias, Koltowska-Haggström Maria, Kohlmann Thomas, Wallaschofski Henri

机构信息

Institut for Community Medicine, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.

出版信息

Eur J Endocrinol. 2009 Jan;160(1):17-24. doi: 10.1530/EJE-08-0738. Epub 2008 Oct 30.

Abstract

OBJECTIVE

To analyse 12-month response to GH treatment in a single-country cohort of hypopituitary adult patients with GH deficiency (GHD) in regards to health-related quality of life (HRQoL) and insulin-like growth factor-1 (IGF-1) compared with values from general population sample. Moreover, association between the response in HRQoL and the IGF-1 values in patients and in the background population was investigated.

DESIGN

HRQoL was assessed by quality of life assessment of GH deficiency in adults (QoL-AGHDA) in 651 patients retrieved from the German KIMS (Pfizer International Metabolic Database) before and after 12 months of GH replacement and in a sample drawn from a cross-sectional study in Germany (n=2734). IGF-1 was measured in KIMS patients and in the population-based study with the same assay technique.

RESULTS

In KIMS patients, mean QoL-AGHDA scores before GH replacement were 9.2+/-6.8 (8.7+/-6.8) in women (men) and in the general population sample 4.5+/-5.3 (4.3+/-5.0) in women (men). Mean differences in QoL-AGHDA scores were statistically significant for all age categories (P<0.05). The mean IGF-1 SDS of KIMS patients before GH replacement was -1.1+/-1.4 (-0.8+/-1.4) in women (men). After GH replacement, a significant increase of IGF-1 concentration and a significant decrease of QoL-AGHDA scores near to age- and gender-specific population-based values were observed.

CONCLUSIONS

This study confirms an improvement in HRQoL and an increase of IGF-1 SDS in GH-replaced adults, which approximated the values of general population. However, there was no association between IGF-1 values and HRQoL assessment as one of the important treatment outcomes.

摘要

目的

分析单国队列中垂体功能减退的成年生长激素缺乏(GHD)患者接受生长激素(GH)治疗12个月后的反应,内容涉及与健康相关的生活质量(HRQoL)和胰岛素样生长因子-1(IGF-1),并与普通人群样本的值进行比较。此外,还研究了患者及背景人群中HRQoL反应与IGF-1值之间的关联。

设计

通过成人生长激素缺乏症生活质量评估(QoL-AGHDA)对651例患者的HRQoL进行评估,这些患者来自德国KIMS(辉瑞国际代谢数据库),在接受GH替代治疗12个月前后进行评估,同时从德国的一项横断面研究中抽取样本(n = 2734)。采用相同的检测技术在KIMS患者和基于人群的研究中测量IGF-1。

结果

在KIMS患者中,GH替代治疗前女性(男性)的平均QoL-AGHDA评分为9.2±6.8(8.7±6.8),而在普通人群样本中,女性(男性)为4.5±5.3(4.3±5.0)。所有年龄组的QoL-AGHDA评分平均差异均具有统计学意义(P<0.05)。GH替代治疗前,KIMS患者女性(男性)的平均IGF-1 SDS为-1.1±1.4(-0.8±1.4)。GH替代治疗后,观察到IGF-1浓度显著增加,QoL-AGHDA评分显著降低,接近基于年龄和性别的人群值。

结论

本研究证实接受GH替代治疗的成年人HRQoL有所改善,IGF-1 SDS增加,接近普通人群的值。然而,作为重要治疗结果之一,IGF-1值与HRQoL评估之间没有关联。

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