TY  - JOUR
PY  - 2015//
TI  - Growth hormone deficiency after traumatic brain injury: improvement in quality of life with GH therapy - analysis of the KIMS database
JO  - European journal of endocrinology
A1  - Gardner, Chris John
A1  - Mattsson, Anders F.
A1  - Daousi, Christina
A1  - Korbonits, Marta
A1  - Koltowska-Haggstrom, Maria
A1  - Cuthbertson, Daniel J.
SP  - 371
EP  - 381
VL  - 172
IS  - 4
N2  - OBJECTIVE: Prevalence of growth hormone (GH) deficiency (GHD) caused by traumatic brain injury (TBI) is highly variable. Short-term studies show improvement in quality of life (QoL) during GH replacement (GHR), but long-term data are lacking. This study aimed to analyse the clinical characteristics of post traumatic hypopituitarism and the QoL effects of long-term GHR. Design/Methods: KIMS (Pfizer International Metabolic Database) patients with GHD caused by TBI and by non-functioning pituitary adenoma (NFPA) were compared regarding: clinical characteristics at baseline and 1-year of GHR, and QoL response up to 8-years of GHR (QoL-AGHDA total scores and dimensions) in relation to country-specific norms. <br><br>RESULTS: TBI patients compared to NFPA patients: were younger, diagnosed with GHD 2.4 years later after primary disease onset (p<0.0001), had a higher incidence of isolated GHD, higher GH peak, a more favourable metabolic profile and worse QoL, were shorter by 0.9 cm (1.8 cm when corrected for age and gender; p=0.004) and received higher GH dose (mean difference: 0.04 mg/day p=0.006). In TBI patients, 1-year improvement in QoL, was greater than in NFPA (change in QoL-AGHDA score 5.0 vs. 3.5, respectively, p=0.04) and was sustained over 8-years. In TBI patients, socialisation normalised after 1 year of GHR, self-confidence and tenseness after 6 years and no normalisation of tiredness and memory was observed. <br><br>CONCLUSION: Compared to NFPA, TBI patients presented biochemically with less severe hypopituitarism and worse QoL scores. GHR achieved clinically relevant, long-term benefit in QoL.<p />  <p>Language: en</p>
LA  - en
SN  - 0804-4643
UR  - http://dx.doi.org/10.1530/EJE-14-0654
ID  - ref1
ER  -