Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
Endocr Pract. 2012 Mar-Apr;18(2):209-18. doi: 10.4158/EP11134.OR.
To compare the response in quality of life (QoL) to growth hormone (GH) replacement in women with GH deficiency (GHD) and a history of acromegaly with that in women with GHD of other causes.
Fifty-five women with GHD were studied: 17 with prior acromegaly and 38 with other causes of GHD. We compared two 6-month, randomized, placebo-controlled studies of GH therapy in women with hypopituitarism conducted with use of the same design-one in women with a history of acromegaly and one in women with no prior acromegaly. QoL was assessed with the following questionnaires: the QoL-Assessment of Growth Hormone Deficiency in Adults (AGHDA), the Symptom Questionnaire, and the 36-Item Short-Form Health Survey (SF-36).
The 2 groups had comparable mean pretreatment age, body mass index, and QoL scores and comparable mean GH dose at 6 months (0.61 ± 0.30 versus 0.67 ± 0.27 mg daily). After 6 months of GH replacement therapy, women with GHD and prior acromegaly demonstrated a greater improvement in AGHDA score, four SF-36 sub-scales (Role Limitations due to Physical Health, Energy or Fatigue, Emotional Well-Being, and Social Functioning), and the Somatic Symptoms subscale of the Symptom Questionnaire than did women with GHD of other causes. Poorer pretreatment QoL was associated with a greater improvement in QoL after administration of GH.
In this study, GH replacement therapy improved QoL in women with GHD and a history of acromegaly but not in women with GHD due to other hypothalamic and pituitary disorders. Further studies are needed to determine the long-term risks versus benefits of GH replacement in patients who develop GHD after definitive treatment for acromegaly.
比较有既往肢端肥大症史的生长激素缺乏症（GHD）女性与其他病因 GHD 女性对生长激素（GH）替代治疗的生活质量（QoL）反应。
研究了 55 例 GHD 女性：17 例有既往肢端肥大症史，38 例有其他病因 GHD。我们比较了两项采用相同设计的垂体功能减退症女性 GH 治疗的 6 个月随机、安慰剂对照研究——一项有既往肢端肥大症史，另一项无既往肢端肥大症史。使用以下问卷评估 QoL：成人 GH 缺乏症 QoL 评估问卷（AGHDA）、症状问卷和 36 项简明健康调查问卷（SF-36）。
两组患者的预处理年龄、体重指数和 QoL 评分均相似，6 个月时的平均 GH 剂量也相似（0.61±0.30 与 0.67±0.27mg/d）。GH 替代治疗 6 个月后，有既往肢端肥大症史的 GHD 女性在 AGHDA 评分、四个 SF-36 子量表（身体机能受限、精力或疲劳、情绪健康和社会功能）和症状问卷的躯体症状子量表方面的改善均大于其他病因 GHD 女性。预处理 QoL 较差与 GH 治疗后 QoL 的改善程度更大相关。
在这项研究中，GH 替代治疗改善了有既往肢端肥大症史的 GHD 女性的 QoL，但对其他下丘脑和垂体疾病导致的 GHD 女性无此作用。需要进一步研究来确定在明确治疗肢端肥大症后发生 GHD 的患者中，GH 替代治疗的长期风险与获益。
