Body composition and quality of life in adults with growth hormone deficiency; effects of low-dose growth hormone replacement

OBJECTIVE Adult growth hormone deficiency (AGHD) is characterized by abnormalities in body composition and a poor perceived quality of life (QoL). Weight‐based high‐dose growth hormone replacement (GHR) results in improvements in body composition and QoL in AGHD. However, a high patient percentage reported side‐effects on high‐dose GHR resulting in a high rate of patient withdrawal from growth hormone (GH) treatment. High‐dose GH therapy also leads to supraphysiological serum insulin‐like growth factor‐I (IGF‐I) concentrations that have been associated with breast and prostate cancer, raising major concerns over the use of such high‐dose GH regimen in AGHD. The aim of this study was to assess the effects of low‐dose growth hormone replacement (GHR) on body composition and QoL as early as 1 and 3 months. STUDY DESIGN A prospective, open treatment design study to determine the early effects of low‐dose GH administration on body composition and QoL. GH was initiated at a daily dose of 0·4–0·5 IU, and titrated up to achieve and maintain IGF‐I standard deviation score (IGF‐I SDS) between the median and upper end of the age‐related reference range. PATIENTS Forty‐six, post‐pituitary surgery, severe AGHD patients (22 women), defined as peak GH response