Qualidade de vida na deficiência isolada e genética do hormônio de crescimento (GH). Efeitos da terapia de reposição com o GH

Abstract

Reduction in the quality of life (QOL) is commonly described in the growth hormone (GH) deficiency, with reports of benefits of GH replacement therapy in QOL. In most of the descriptions, GH deficiency is not isolated, of adult onset type and has multiple causes with its respective treatments that by themselves can influence QOL. In the present work we evaluated (QOL) by the questionnaire Questions on Life Satisfaction Hypopituitarism Module (QLS-H) in 20 adult with isolated deficiency of GH (IGHD) due to a mutation in the GH releasing hormone receptor gene (IGHD, 10 men) comparing with 20 controls (CO, 10 men). Additionally IGHD group was evaluated after 6 months of treatment with long acting GH (Nutropin Depot®, Genentech ) given subcutaneously every 15 days ( pGH) and after 12 months of its interruption (12M). There was not difference in the total score of QOL (TSQOL) among the groups IGHD and CO, 90(50,25) and 93 (79,25) respectively, median (interquartile range) and nor in any of the nine categories that composes the TSQOL. Similar results were obtained when data were analyzed by sex. Despite modest but significant trough serum insulin like growth factor I (IGF-I) increase GH treatment didn't influence TSQOL in pGH 100(51) and 12M 93(38). Only the score of perception of the satisfaction with the physical resistance increased (p=0,01) in the time pGH. In conclusion, genetic and lifelong DIGH doesn't reduce the QOL and the treatment with long-acting GH for 6 months didn't also influence it, in spite of the improvement of the perception of the satisfaction with the physical resistance, obtained with the treatment.