Giusti M, Meineri I, Malagamba D, Cuttica C M, Fattacciu G, Menichini U, Rasore E, Giordano G
DiSEM, Cattedra di Endocrinologia, University of Genova, Genoa, Italy.
Eur J Clin Invest. 1998 Jan;28(1):13-9. doi: 10.1046/j.1365-2362.1998.00239.x.
We examined the effect of growth hormone (GH) administration on the psychological capacity and sense of well-being in 25 patients with adult-onset GH-deficiency (GHD).
Very low dosages [0.5-1.0 UIday(-1) s.c. at bed-time] of recombinant human (rh)-GH (n = 13; aged 50+/-15 years, mean+/-SD) or placebo (n = 12, 53+/-14 years) were given at random for a 6-month period. Quality of life was assessed by using the Italian version of the self-rating Kellner Symptom Questionnaire (KSQ) and the Hamilton Depression Scale (HDS).
No difference in insulin-like growth factor I (IGF-I) levels was noted between groups on entry to the study. A significant increase in IGF-I [month 0 56.2+/-10.4 microg L(-1) vs. month 6 125.7+/-16.7 microg L(-1); P < 0.001] levels was noted only in the rh-GH-treated group. There was no difference in overall scores on the KSQ between the rh-GH-treated and control groups on entry. A slight, non-significant, decrease in overall scores was noted in both groups of subjects. Subsection analysis of items from the KSQ did not show significant differences in either group during the 6-month period. A significant decrease (month 0 28+/-1 vs. month 6 25+/-1; P = 0.02) in the HDS score was noted in rh-GH-treated but not in placebo-treated patients. There was a significant correlation (rs, -0.56, P = 0.05) between increase in IGF-I levels and decrease in HDS scores in rh-GH treated patients.
The data demonstrate that low rh-GH dosages significantly improve psychological profiles as rated by HDS evaluation in adult-onset patients with GHD. On the other hand, a 6-month period of treatment does not produce any significant differences in quality of life as measured by KSQ between treated patients and placebo controls.
我们研究了生长激素（GH）给药对25例成年起病型生长激素缺乏症（GHD）患者心理能力和幸福感的影响。
随机给予极低剂量[睡前皮下注射0.5 - 1.0 UI/天]的重组人生长激素（rh-GH，n = 13；年龄50±15岁，均值±标准差）或安慰剂（n = 12，53±14岁），为期6个月。使用意大利版的自评凯尔纳症状问卷（KSQ）和汉密尔顿抑郁量表（HDS）评估生活质量。
研究开始时两组间胰岛素样生长因子I（IGF-I）水平无差异。仅在rh-GH治疗组中观察到IGF-I水平显著升高[第0个月56.2±10.4 μg/L vs. 第6个月125.7±16.7 μg/L；P < 0.001]。rh-GH治疗组和对照组在研究开始时KSQ的总分无差异。两组受试者的总分均有轻微、不显著的下降。KSQ项目的亚组分析在6个月期间两组均未显示出显著差异。rh-GH治疗的患者HDS评分显著下降（第0个月28±1 vs. 第6个月25±1；P = 0.02），而安慰剂治疗的患者未出现这种情况。在rh-GH治疗的患者中，IGF-I水平升高与HDS评分下降之间存在显著相关性（rs，-0.56，P = 0.05）。
数据表明，低剂量rh-GH可显著改善成年起病型GHD患者经HDS评估的心理状况。另一方面，治疗6个月在经KSQ测量的生活质量方面，治疗患者与安慰剂对照组之间未产生任何显著差异。
