Impact of recombinant human growth hormone (rh-GH) treatment on psychiatric, neuropsychological and clinical profiles of GH deficient adults: a placebo - controlled trial

Impacto do tratamento com hormônio de crescimento recombinante (rh-GH) sobre as características psiquiátricas, neuropsicológicas e clínicas de adultos com deficiência de GH: ensaio clínico duplo-cego controlado com placebo

CLÁUDIO DE NOVAES SOARES NINA ROSA MUSOLINO MALEBRANCHE CUNHA NETO MARIA ADELAIDE CAIRES MARIA CRISTINA ROSENTHAL CANDIDA PIRES CAMARGO MARCELLO D. BRONSTEIN About the authors

BACKGROUND: Untreated GH-deficient adults have a diversity of dysfunctions (e.g. reduced muscle strength, emotional instability during stress, depressive symptoms) that may cause deleterious effects on quality of life, and may be positively influenced by recombinant human growth hormone (rh-GH) therapy. AIM: To evaluate the impact of a clinical intervention with rh-GH therapy on GH - deficient adults. METHOD: The physical, psychiatric and neuropsychological status of 9 GH-deficient adults was determined before and after the administration of rh-GH (0.250 IU/Kg/week) in a double blind placebo-controlled trial for six months. Patients then received rh-GH for a further period of 6 months and their status was re-evaluated. RESULTS: Rh-GH was significant better than placebo at 6th month (p<0.05), producing increased serum Insulin like growth factor-I (IGF-1) levels, reduced body mass index (BMI) and body fat, increased lean body mass and water, reduced waist/hip ratio and increased energy expenditure. The rh-GH therapy was also significantly better than placebo on depressive features as measured by the Hamilton Depression Scale (17-items) (p= 0.0431) and the Beck Depression Inventory (p= 0.0431). Neuropsychological evaluations showed significant improvements in measures of Attention: Digit Backward (p= 0.035),Verbal Fluency (FAS) (p= 0.02) and Cognitive Efficiency (WAIS-R tests): Vocabulary (p= 0.027) , Picture Arrangements (p= 0.017), and Comprehension (p= 0.01) following rh-GH therapy. CONCLUSION: The clinical, psychiatric, and neuropsychological impairments of untreated GH-deficient adults can be decreased by rh-GH therapy.

growth-hormone deficiency; adult; treatment; psychiatry; depression


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