Abdi Lyès, Sahnoun-Fathallah Mona, Morange Isabelle, Albarel Frédérique, Castinetti Frédéric, Giorgi Roch, Brue Thierry
Aix-Marseille université, CNRS, CRN2M UMR 7286, 13344 Marseille cedex 15, France; Service d'endocrinologie, diabète et maladies métaboliques, centre de référence des maladies rares d'origine hypophysaire DEFHY, hôpital Timone, AP-HM, 13385 Marseille cedex 15, France; Service endocrinologie, hôpitaux Drome-Nord, 607, avenue Geneviève-de-Gaulle-Anthonioz, BP 1002, 26102 Romans-sur-Isère cedex, France.
Aix-Marseille université, CNRS, CRN2M UMR 7286, 13344 Marseille cedex 15, France; Service d'endocrinologie, diabète et maladies métaboliques, centre de référence des maladies rares d'origine hypophysaire DEFHY, hôpital Timone, AP-HM, 13385 Marseille cedex 15, France.
Ann Endocrinol (Paris). 2014 Jul;75(3):176-83. doi: 10.1016/j.ando.2014.05.002. Epub 2014 Jul 2.
To describe the results of growth hormone (GH) therapy in adult GH-deficient patients treated in a tertiary referral center, with a focus on quality of life and adherence.
Retrospective study of patients followed over a total period of 11 years. Quality of life (QOL) was assessed by the QOL-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) score and adherence to treatment was measured by a specific questionnaire. Clinical, biological, body composition and bone mineralization parameters were also analyzed.
Data from 81 patients were analyzed. After a median treatment duration of 7 years, 2/3 of patients reported improved QOL (mean decrease of AGHDA score of 3.0 points, P<0.001). A trend towards more frequent improvement was observed in middle-aged patients, women, childhood-onset GHD, and in patients with initially more impaired QOL. More than 60% of the patients reported continuing treatment without interruption. Seventy percent declared good adherence (≤2 missed injections/month). A majority reported enhanced well-being. Additionally, we observed a mean weight increase of 2 kg, while fat mass, waist/hip circumference ratio and lipids were unchanged. Bone mineral density was significantly increased at lumbar spine and femoral neck.
Our study confirmed a sustained improvement in quality of life and showed that majority of patients were still on GH treatment after a median duration of 7 years.
描述在一家三级转诊中心接受治疗的成年生长激素缺乏患者的生长激素(GH)治疗结果,重点关注生活质量和依从性。
对随访11年的患者进行回顾性研究。通过成人生长激素缺乏症生活质量评估(QoL-AGHDA)评分评估生活质量,并通过特定问卷测量治疗依从性。还分析了临床、生物学、身体成分和骨矿化参数。
分析了81例患者的数据。中位治疗时间为7年后,2/3的患者报告生活质量有所改善(AGHDA评分平均降低3.0分,P<0.001)。在中年患者、女性、儿童期起病的生长激素缺乏症患者以及初始生活质量受损更严重的患者中,观察到更频繁改善的趋势。超过60%的患者报告持续不间断治疗。70%的患者宣称依从性良好(每月漏注射≤2次)。大多数患者报告幸福感增强。此外,我们观察到平均体重增加2千克,而脂肪量、腰臀围比和血脂未发生变化。腰椎和股骨颈的骨密度显著增加。
我们的研究证实生活质量持续改善,并表明中位治疗7年后大多数患者仍在接受生长激素治疗。