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Health-Related Quality of Life of Young Adults Treated with Recombinant Human Growth Hormone during Childhood.

Sommer G, Gianinazzi ME, Kuonen R, Bohlius J, l'Allemand D, Hauschild M, Mullis PE, Kuehni CE, Swiss Society for Paediatric Endocrinology and Diabetology (SGPE - PLoS ONE (2015)

Bottom Line: Lower Physical Component Summary was associated with lower educational level (coeff. -1.9).Final height was not associated with HRQoL.In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment.

View Article: PubMed Central - PubMed

Affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

ABSTRACT

Background: Since recombinant human growth hormone (rhGH) became available in 1985, the spectrum of indications has broadened and the number of treated patients increased. However, long-term health-related quality of life (HRQoL) after childhood rhGH treatment has rarely been documented. We assessed HRQoL and its determinants in young adults treated with rhGH during childhood.

Methodology/principal findings: For this study, we retrospectively identified former rhGH patients in 11 centers of paediatric endocrinology, including university hospitals and private practices. We sent a questionnaire to all patients treated with rhGH for any diagnosis, who were older than 18 years, and who resided in Switzerland at time of the survey. Three hundred participants (58% of 514 eligible) returned the questionnaire. Mean age was 23 years; 56% were women; 43% had isolated growth hormone deficiency, or idiopathic short stature; 43% had associated diseases or syndromes, and 14% had growth hormone deficiency after childhood cancer. Swiss siblings of childhood cancer survivors and the German norm population served as comparison groups. HRQoL was assessed using the Short Form-36. We found that the Physical Component Summary of healthy patients with isolated growth hormone deficiency or idiopathic short stature resembled that of the control group (53.8 vs. 54.9). Patients with associated diseases or syndromes scored slightly lower (52.5), and former cancer patients scored lowest (42.6). The Mental Component Summary was similar for all groups. Lower Physical Component Summary was associated with lower educational level (coeff. -1.9). Final height was not associated with HRQoL.

Conclusions/significance: In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment. Patients with isolated growth hormone deficiency/idiopathic short stature or patients with associated diseases or syndromes had HRQoL comparable to peers. Patients with growth hormone deficiency after childhood cancer were at high risk for lower HRQoL. This reflects the general impaired health of this vulnerable group, which needs long-term follow-up.

No MeSH data available.


Related in: MedlinePlus

SF-36 mean T-scores of rhGH-treated patients, stratified by indication groups and compared to Swiss controls.Fig 2 shows mean T-scores for the eight SF-36 subscales and the two summary scores of rhGH treated patients, stratified by indication groups and compared to Swiss controls. Swiss controls means were unadjusted. Higher T-scores indicate higher HRQoL (expected mean from German norm population = 50, SD = 10). P-values to compare means between rhGH treated patients and Swiss controls were calculated using linear regression models.aGroup I includes healthy patients with IGHD or ISS; bGroup II patients with associated diseases or syndromes; cGroup III childhood cancer survivors with GHD. Abbreviations: GHD, growth hormone deficiency; IGHD, isolated growth hormone deficiency; ISS, idiopathic short stature; rhGH, recombinant human growth hormone; SF-36, Short Form-36.
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pone.0140944.g002: SF-36 mean T-scores of rhGH-treated patients, stratified by indication groups and compared to Swiss controls.Fig 2 shows mean T-scores for the eight SF-36 subscales and the two summary scores of rhGH treated patients, stratified by indication groups and compared to Swiss controls. Swiss controls means were unadjusted. Higher T-scores indicate higher HRQoL (expected mean from German norm population = 50, SD = 10). P-values to compare means between rhGH treated patients and Swiss controls were calculated using linear regression models.aGroup I includes healthy patients with IGHD or ISS; bGroup II patients with associated diseases or syndromes; cGroup III childhood cancer survivors with GHD. Abbreviations: GHD, growth hormone deficiency; IGHD, isolated growth hormone deficiency; ISS, idiopathic short stature; rhGH, recombinant human growth hormone; SF-36, Short Form-36.

Mentions: When we stratified the rhGH patients by indication group (Table 2 and Fig 2), we found that mean scores of patients in Groups II and III were significantly different from those of Swiss controls. Group II scored lower in the following scales: physical functioning (mean of 49.3 vs. 53.1); general health perception (52.8 vs. 56.5); and, the PCS (52.5 vs. 54.9). Patients in Group III had the lowest scores in all scales. Their scores for physical functioning (36.0 vs. 53.1), role limitation physical (43.1 vs. 50.9), general health perception (46.7 vs. 56.5), social functioning (44.3 vs. 50.8), and the PCS (42.6 vs. 54.9) were significantly lower.


Health-Related Quality of Life of Young Adults Treated with Recombinant Human Growth Hormone during Childhood.

Sommer G, Gianinazzi ME, Kuonen R, Bohlius J, l'Allemand D, Hauschild M, Mullis PE, Kuehni CE, Swiss Society for Paediatric Endocrinology and Diabetology (SGPE - PLoS ONE (2015)

SF-36 mean T-scores of rhGH-treated patients, stratified by indication groups and compared to Swiss controls.Fig 2 shows mean T-scores for the eight SF-36 subscales and the two summary scores of rhGH treated patients, stratified by indication groups and compared to Swiss controls. Swiss controls means were unadjusted. Higher T-scores indicate higher HRQoL (expected mean from German norm population = 50, SD = 10). P-values to compare means between rhGH treated patients and Swiss controls were calculated using linear regression models.aGroup I includes healthy patients with IGHD or ISS; bGroup II patients with associated diseases or syndromes; cGroup III childhood cancer survivors with GHD. Abbreviations: GHD, growth hormone deficiency; IGHD, isolated growth hormone deficiency; ISS, idiopathic short stature; rhGH, recombinant human growth hormone; SF-36, Short Form-36.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608786&req=5

pone.0140944.g002: SF-36 mean T-scores of rhGH-treated patients, stratified by indication groups and compared to Swiss controls.Fig 2 shows mean T-scores for the eight SF-36 subscales and the two summary scores of rhGH treated patients, stratified by indication groups and compared to Swiss controls. Swiss controls means were unadjusted. Higher T-scores indicate higher HRQoL (expected mean from German norm population = 50, SD = 10). P-values to compare means between rhGH treated patients and Swiss controls were calculated using linear regression models.aGroup I includes healthy patients with IGHD or ISS; bGroup II patients with associated diseases or syndromes; cGroup III childhood cancer survivors with GHD. Abbreviations: GHD, growth hormone deficiency; IGHD, isolated growth hormone deficiency; ISS, idiopathic short stature; rhGH, recombinant human growth hormone; SF-36, Short Form-36.
Mentions: When we stratified the rhGH patients by indication group (Table 2 and Fig 2), we found that mean scores of patients in Groups II and III were significantly different from those of Swiss controls. Group II scored lower in the following scales: physical functioning (mean of 49.3 vs. 53.1); general health perception (52.8 vs. 56.5); and, the PCS (52.5 vs. 54.9). Patients in Group III had the lowest scores in all scales. Their scores for physical functioning (36.0 vs. 53.1), role limitation physical (43.1 vs. 50.9), general health perception (46.7 vs. 56.5), social functioning (44.3 vs. 50.8), and the PCS (42.6 vs. 54.9) were significantly lower.

Bottom Line: Lower Physical Component Summary was associated with lower educational level (coeff. -1.9).Final height was not associated with HRQoL.In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment.

View Article: PubMed Central - PubMed

Affiliation: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

ABSTRACT

Background: Since recombinant human growth hormone (rhGH) became available in 1985, the spectrum of indications has broadened and the number of treated patients increased. However, long-term health-related quality of life (HRQoL) after childhood rhGH treatment has rarely been documented. We assessed HRQoL and its determinants in young adults treated with rhGH during childhood.

Methodology/principal findings: For this study, we retrospectively identified former rhGH patients in 11 centers of paediatric endocrinology, including university hospitals and private practices. We sent a questionnaire to all patients treated with rhGH for any diagnosis, who were older than 18 years, and who resided in Switzerland at time of the survey. Three hundred participants (58% of 514 eligible) returned the questionnaire. Mean age was 23 years; 56% were women; 43% had isolated growth hormone deficiency, or idiopathic short stature; 43% had associated diseases or syndromes, and 14% had growth hormone deficiency after childhood cancer. Swiss siblings of childhood cancer survivors and the German norm population served as comparison groups. HRQoL was assessed using the Short Form-36. We found that the Physical Component Summary of healthy patients with isolated growth hormone deficiency or idiopathic short stature resembled that of the control group (53.8 vs. 54.9). Patients with associated diseases or syndromes scored slightly lower (52.5), and former cancer patients scored lowest (42.6). The Mental Component Summary was similar for all groups. Lower Physical Component Summary was associated with lower educational level (coeff. -1.9). Final height was not associated with HRQoL.

Conclusions/significance: In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment. Patients with isolated growth hormone deficiency/idiopathic short stature or patients with associated diseases or syndromes had HRQoL comparable to peers. Patients with growth hormone deficiency after childhood cancer were at high risk for lower HRQoL. This reflects the general impaired health of this vulnerable group, which needs long-term follow-up.

No MeSH data available.


Related in: MedlinePlus