Research Institute for Pituitary Disease, Southern Tohoku General Hospital, Koriyama, Japan.
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan.
Hormones (Athens). 2016 Jan-Mar;15(1):45-53. doi: 10.14310/horm.2002.1637.
We evaluated the long-term effects of growth hormone (GH) on markers of quality of life, glucose metabolism, and lipid metabolism to validate the adequacy of long-term GH replacement therapy for adult GH deficiency (AGHD).
Eighty-three of 100 sequentially followed patients who received GH therapy were selected for this study. Forty-nine were men aged 26 to 78 years (mean, 52 years) and 34 were women aged 20 to 78 years (mean, 56 years). The GH-releasing peptide-2 stimulation test and arginine stimulation test were used to diagnose AGHD. The adult hypopituitarism questionnaire (AHQ) and biochemical parameters such as cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, and gyrated hemoglobin (HbA1c) were determined before treatment, at 6 months of treatment, and at 1, 2, 3, 4, 5, 6, 7, and 8 years of treatment. Considering age and sex as factors potentially influencing the effect of GH therapy, the patients were divided into age groups of <60 and ≥60 years and sex groups of men and women. Repeated measured analysis of variance (ANOVA) was employed.
ANOVA demonstrated significant changes in mean AHQ scores during follow-up. Comparison of individual AHQ scores with baseline values revealed sequential improvements, stabilization, and decline in QOL. A significant elevation in HbA1c level was demonstrated. LDL-C and HDL-C levels changed significantly upon GH treatment regardless of sex or age. Levels of glucose, TC or TG did not change significantly.
The effect of GH therapy on QOL showed sequential improvements and stabilization until 6-year follow-up.
评估生长激素（GH）对生活质量、葡萄糖代谢和脂代谢标志物的长期影响，以验证长期 GH 替代治疗成人 GH 缺乏症（AGHD）的充分性。
对接受 GH 治疗的 100 例连续随访患者中的 83 例进行了本研究选择。49 例为男性，年龄 26 至 78 岁（平均 52 岁），34 例为女性，年龄 20 至 78 岁（平均 56 岁）。使用生长激素释放肽-2 刺激试验和精氨酸刺激试验诊断 AGHD。成人垂体功能减退问卷（AHQ）和生化参数，如胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）胆固醇和低密度脂蛋白（LDL）胆固醇以及糖化血红蛋白（HbA1c）在治疗前、治疗 6 个月以及治疗 1、2、3、4、5、6、7 和 8 年后进行测定。考虑到年龄和性别可能影响 GH 治疗效果的因素，将患者分为<60 岁和≥60 岁年龄组和男性和女性性别组。采用重复测量方差分析（ANOVA）。
ANOVA 显示在随访过程中平均 AHQ 评分有显著变化。与基线值相比，个别 AHQ 评分的比较显示 QOL 依次改善、稳定和下降。HbA1c 水平显著升高。无论性别或年龄如何，LDL-C 和 HDL-C 水平在 GH 治疗后均发生显著变化。血糖、TC 或 TG 水平无明显变化。
GH 治疗对 QOL 的影响在 6 年随访时显示出依次改善和稳定。
