Die Lebensqualität junger Erwachsener nach einer Wachstumshormonbehandlung im Kindesalter

 

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Zusammenfassung

Hintergrund und Fragestellung: Die gesundheitsbezogene Lebensqualität von Patienten mit idiopathischem Wachstumshormonmangel oder neurosekretorischer Dysfunktion, die im Kindesalter mit einem rekombinanten humanen Wachstumshormon (growth hormone, GH) behandelt wurden, ist bisher wenig untersucht.

Patienten und Methodik: In die Querschnittstudie wurden ehemalige Patienten der endokrinologischen Abteilung der Kinder- und Jugendklinik des Universitätsklinikums Erlangen nach abgeschlossener GH-Therapie (N = 85) einbezogen. Nachdem sich in den auxologischen Daten keine Unterschiede fanden, wurden die Daten der beiden Diagnosegruppen gemeinsam analysiert. Erfasst wurde die gesundheitsbezogene Lebensqualität mit dem Short Form-36 Health Survey und dem Nottingham Health Profile, für die bevölkerungsrepräsentative Daten vorliegen.

Ergebnisse: Die Patienten (53 m, 32 w) waren zum Erhebungszeitpunkt 23,5 ± 4,6 Jahre alt. Das Alter lag bei Therapiebeginn bei 10,5 ± 2,8 und am Ende der Therapie bei 16,3 ± 1,4 Jahren. Die Abweichung der Körperhöhe betrug zu Beginn -3,20 ± 1,06 Standard Deviation Scores (SDS). Die GH-Dosis lag zu Beginn bei 0,026 ± 0,012 mg/kg/Tag. Die GH-Injektionen erfolgten täglich subkutan. Der Zugewinn an Körperhöhe lag am Ende der Therapie bei 1,69 ± 1,22 SDS. Im Vergleich zu der Normstichprobe wiesen die Patienten nach beendeter Therapie mangelnde Energie, verminderte Vitalität, beeinträchtigte soziale Funktionsfähigkeit, höhere soziale Isolation, eine stärkere emotionale Reaktion, erhöhten Mobilitätsverlust sowie eine schlechtere psychische Befindlichkeit auf.

Folgerung: Jungerwachsene Patienten zeigten nach Abschluss der Wachstumshormontherapie Beeinträchtigungen in ihrer Lebensqualität.

Abstract

Introduction: Little is known about the health-related quality of life of young adults with childhood onset idiopathic growth hormone deficiency or neurosecretory dysfunction of growth hormone secretion, who have been treated with recombinant human growth hormone (GH).

Methods: Patients were diagnosed and treated with human growth hormone at the University Children´s Hospital in Erlangen (n=85). The data of both groups were merged for analysis, because no difference between idiopathic growth hormone deficiency and neurosecretory dysfunction of growth hormone secretion in auxological. Data were found. Health-related quality of life was cross- sectionally assessed after the end of growth hormone therapy with the Short Form-36 Health Survey and the Nottingham Health Profiles for which population based norm data are available.

Results: At the time of the survey, the patients (53 m, 32 f) were 23.5 ± 4.6 years old. At start of GH therapy, age was 10.5 ± 2.8 and at the end 16.3 ± 1,4 years. At start, height SDS was -3.20 ± 1.06. GH dose was 0,026 ± 0,012 mg/kg/d (daily s. c.-injections). The increase in height SDS after the end of GH therapy was 1.69 ± 1.22.  Compared to the reference population, patients reported significantly lower scores on the scales energy level, vitality, social functioning, indicating a greater social isolation, a stronger emotional reaction, an increased loss of mobility and a worse psychological state.

Conclusion: Young adults report specific impairments after completion of GH therapy.

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