THERAPY IN ENDOCRINE DISEASE: Body composition and quality of life in adults treated with GH therapy: a systematic review and meta-analysis

Author:

Hazem Ahmad,Elamin Mohamed B,Bancos Irina,Malaga German,Prutsky Gabriela,Domecq Juan Pablo,Elraiyah Tarig A,Abu Elnour Nisrin O,Prevost Yolanda,Almandoz Jaime P,Zeballos-Palacios Claudia,Velasquez Edgar R,Erwin Patricia J,Natt Neena,Montori Victor M,Murad Mohammad Hassan

Abstract

ObjectiveTo summarise the evidence about the efficacy and safety of using GH in adults with GH deficiency focusing on quality of life and body composition.Data sourcesWe searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science and Scopus through April 2011. We also reviewed reference lists and contacted experts to identify candidate studies.Study selectionReviewers, working independently and in duplicate, selected randomised controlled trials (RCTs) that compared GH to placebo.Data synthesisWe pooled the relative risk (RR) and weighted mean difference (WMD) by the random effects model and assessed heterogeneity using theI2statistic.ResultsFifty-four RCTs were included enrolling over 3400 patients. The quality of the included trials was fair. GH use was associated with statistically significant reduction in weight (WMD, 95% confidence interval (95% CI): −2.31 kg, −2.66 and −1.96) and body fat content (WMD, 95% CI: −2.56 kg, −2.97 and −2.16); increase in lean body mass (WMD, 95% CI: 1.38, 1.10 and 1.65), the risk of oedema (RR, 95% CI: 6.07, 4.34 and 8.48) and joint stiffness (RR, 95% CI: 4.17, 1.4 and 12.38); without significant changes in body mass index, bone mineral density or other adverse effects. Quality of life measures improved in 11 of the 16 trials although meta-analysis was not feasible.ResultsGH therapy in adults with confirmed GH deficiency reduces weight and body fat, increases lean body mass and increases oedema and joint stiffness. Most trials demonstrated improvement in quality of life measures.

Publisher

Bioscientifica

Subject

Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism

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