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Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania

Institut for Community Medicine, Ernst Moritz Arndt University of Greifswald, Walther-Rathenau-Straße 48, D-17475 Greifswald, Germany¹ Department of Gastroenterology, Endocrinology and Nutrition² Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Greifswald, Germany³ Pfizer Endocrine Care, Sollentuna, Sweden⁴ Department of Pharmacy, Uppsala University, Uppsala, Sweden

(Correspondence should be addressed to J Moock; Email: joern.moock{at}uni-greifswald.de)

^* (T Kohlmann and H Wallaschofski contributed equally)

Objective: To analyse 12-month response to GH treatment in a single-country cohort of hypopituitary adult patients with GH deficiency (GHD) in regards to health-related quality of life (HRQoL) and insulin-like growth factor-1 (IGF-1) compared with values from general population sample. Moreover, association between the response in HRQoL and the IGF-1 values in patients and in the background population was investigated.

Design: HRQoL was assessed by quality of life assessment of GH deficiency in adults (QoL-AGHDA) in 651 patients retrieved from the German KIMS (Pfizer International Metabolic Database) before and after 12 months of GH replacement and in a sample drawn from a cross-sectional study in Germany (n=2734). IGF-1 was measured in KIMS patients and in the population-based study with the same assay technique.

Results: In KIMS patients, mean QoL-AGHDA scores before GH replacement were 9.2±6.8 (8.7±6.8) in women (men) and in the general population sample 4.5±5.3 (4.3±5.0) in women (men). Mean differences in QoL-AGHDA scores were statistically significant for all age categories (P<0.05). The mean IGF-1 SDS of KIMS patients before GH replacement was –1.1±1.4 (–0.8±1.4) in women (men). After GH replacement, a significant increase of IGF-1 concentration and a significant decrease of QoL-AGHDA scores near to age- and gender-specific population-based values were observed.

Conclusions: This study confirms an improvement in HRQoL and an increase of IGF-1 SDS in GH-replaced adults, which approximated the values of general population. However, there was no association between IGF-1 values and HRQoL assessment as one of the important treatment outcomes.