GHT does not improve QOL in all conditions
C Eiser1, N P Wright2, G Butler3 & S C Otero1
Growth hormone treatment (GHT) is used to improve height, and potentially quality of life (QOL), in children with abnormal growth patterns. Previous QOL research suggests children with acquired growth hormone deficiency (AGHD) benefit more from GHT than those treated for other conditions.
The aim was to determine child and parent reported QOL change over 1 year depending on GHT and diagnosis.
One hundred and twenty-two children (mean age=11.3 years) were recruited from 16 UK endocrinology clinics. Inclusion criteria were diagnoses of idiopathic growth hormone deficiency (IGHD; n=36), AGHD (n=27), Turner syndrome (n=18), and a control group of short stature children referred to endocrinology units who were not prescribed GHT (n=41); aged 517 years, with no other chronic condition and not treated with sex hormones. Parents, and children over 10 years, completed measures of the childs quality of life (PedsQLTM) on beginning GHT (T1), after 6 months (T2) and 12 months (T3).
To date, 62 children and parents of 112 children have completed questionnaires. There were no age differences between diagnostic groups. Increase in stature from T1 to T3 in GHT groups was equivalent to controls (all t-tests n.s.; IGHD:7.8 cm; AGHD:7.2 cm; Turner:7.4 cm; controls:6.8 cm). A diagnosis by time repeated-measures ANOVA on child PedsQLTM scores revealed improvements over time (T1=75.0, T2=77.5, T3=81.4) P=0.001, that were not related to diagnosis. Repeating the analysis with parent ratings of child QOL revealed similar increments over time (T1=69.1, T2=73.9, T3=75.0) P<.001, also not related to diagnosis. However, post hoc tests showed parents of AGHD children reported lower QOL overall P=.001 and at T1 for AGHD (mean=58.1) compared to all other groups (means: IGHD=68.1, Turner=66.0, Control=74.7); P=.007.
Current data do not suggest GHT is associated with improved QOL over a 1 year period. However, a lower overall QOL in children with AGHD suggests GHT should be particularly considered for this group.