Factors influencing the desire for long-term XXXX replacement in adults.

@entity1 @entity2338 @entity2301 @entity442 @entity2124 @entity74 @entity7961 @entity214
OBJECTIVE: @entity2124 replacement in adults may be considered beneficial by clinicians, but @entity1 may not perceive any benefits. The purpose of this study was to determine whether there were any factors which influenced whether an adult wished to continue on long-term GH replacement after taking part in a study of GH replacement. DESIGN: A 12-month study (double-blind placebo controlled for the first 6 months and open for the second 6 months) of GH replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) in adults. @entity1 : Sixty-three adults (27 @entity1 , 36 @entity1 , aged 34.9 +/- 1.4 (mean +/- SE, range 20.1-59.5) years) with @entity2338 (peak serum GH response to provocative testing less than 10 mU/l) who entered a 12-month study of GH replacement. Thirty @entity1 (48%) wished to continue on GH replacement and 33 @entity1 (52%) did not wish to continue on GH replacement after the study. MEASUREMENTS: Biochemical, anthropometric and demographic characteristics, and well-being, were compared in those @entity1 who wished to continue on long-term GH replacement and in those who did not. In the two groups of @entity1 the age, height, weight, body mass index, serum @entity442 , @entity2301 and @entity442 age matched standard deviation score ( @entity214 ) were compared at entry into the study, and changes in @entity442 , @entity2301 and @entity442 SDS were compared after 6 months of GH replacement. The @entity1 were compared according to pretreatment peak serum GH response to provocative testing, sex, estimated duration of @entity2338 , whether @entity2338 was of childhood or adult onset, presence or absence of additional @entity7961 , underlying @entity74 , previous therapeutic interventions, employment status, marital status and living arrangement, and according to development of side-effects of GH replacement and the requirement for reduction in dose of GH because of side-effects during the study. Scores on two questionnaire measures of well-being or distress, the Nottingham Health Profile (NHP) and the Psychological General Well-Being Schedule (PGWBS), were compared at entry into the study in the two groups, as were change in scores on these questionnaires after 6 months of GH replacement. RESULTS: Those who continued on GH replacement tended to have a greater severity of @entity2338 (median peak serum GH concentration 0.7 vs 2.3 mU/l, P = 0.06), tended to have greater distress in terms of energy (NHP, P = 0.06) and vitality (PGWBS, P = 0.06) at entry into the study and showed an improvement in energy during the study compared with no change in those who did not wish to continue on GH replacement (NHP, P = 0.06). CONCLUSION: Those adults who wished to continue on GH replacement tended to have a greater severity of @entity2338 , to experience more distress in terms of energy and vitality at entry into the study and to experience an improvement in energy after 6 months treatment with GH.
