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

PLoS One. 2015 Oct 16;10(10):e0140944. doi: 10.1371/journal.pone.0140944. eCollection 2015.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Health*
  • Human Growth Hormone / pharmacology*
  • Humans
  • Male
  • Mental Health
  • Molecular Sequence Data
  • Quality of Life*
  • Recombinant Proteins / pharmacology*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Recombinant Proteins
  • Human Growth Hormone

Associated data

  • GENBANK/WI172069

Grant support

This study was supported by the Swiss Cancer League (http://www.krebsliga.ch; KLS-02586-02-2010; KLS-2948-02-2012), the 7th framework program of the European Union (http://ec.europa.eu/research/fp7/index_en.cfm; Grant Agreement Number HEALTH-F2-2009-223497 (SAGhE)), Pfizer AG (www.pfizer.com; WI172069), Novo Nordisk Pharma AG (http://www.novonordisk.com), and Sandoz Pharmaceuticals AG (http://www.sandoz.com). All funding was granted to PEM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.