Background/Aims: The effects of growth hormone deficiency (GHD) on linear growth in children are well documented, but there is less convincing evidence regarding the impact on health-related quality of life (QOL). We examined QOL in children aged 8–16 years with acquired GHD following treatment for malignancy (AGHD) or idiopathic GHD (IGHD) on commencing growth hormone treatment (GHT) over 6 months. We adopted a longitudinal design involving consecutive patients and their families attending clinic over an 18-month period. Mothers and children were invited to complete questionnaires before GHT (T1) and 6 months later (T2). Methods: Mothers of 22 children (AGHD n = 14; IGHD n = 8) completed standardized measures of child QOL and behaviour. Children completed parallel measures of QOL, short-term memory tasks and fitness either in clinic or at the family home. Results: For children with AGHD, QOL was significantly below population norms at T1 and improved over time. For children diagnosed with IGHD, QOL at T1 was below, but comparable with population norms. QOL improved over time, though not significantly. Conclusion: GHT is potentially valuable for improving QOL in children, especially in cases of AGHD. We conclude that benefits of GHT for QOL need to be evaluated independent of different diagnostic groups.

1.
Bryant J, Cave C, Mihaylova B, Chase D, McIntyre L, Gerard K, Milne R: Clinical effectiveness and cost effectiveness of growth hormone in children: a systematic review and economic evaluation. Health Technol Assess 2002;6(18):1–106.
2.
Holmes SJ, Shalet SM: Factors influencing the desire for long-term growth-hormone replacement in adults. Clin Endocrinol 1995;43:151–157.
3.
Deijen JB, de Boer H, van der Veen EA: Cognitive changes during growth hormone replacement in adult men. Psychoneuroendocrinology 1998;23:45–55.
4.
Arwert LI, Deijen JB, Muller M, Drent ML: Long-term growth hormone treatment preserves GH-induced memory and mood improvements: a 10-year follow-up study in GH-deficient adult men. Horm Behav 2005;47:343–349.
5.
Murray RD, Brennan BMD, Rahim A, Shalet SM: Survivors of childhood cancer: long-term endocrine and metabolic problems dwarf the growth disturbance. Acta Pediatr Suppl 1999;88:5–12.
6.
Spoudeas HA, Charmandari E, Brook CG: Hypothalamo-pituitary adrenal axis integrity after cranial irradiation for childhood posterior fossa tumours. J Med Pediatr Oncol 2003;40:224–229.
7.
Ogilivy-Stuart AL, Shalet SM: Growth and puberty after growth hormone treatment after irradiation for brain tumours. Arch Dis Child 1995;73:141–146.
8.
Pilpel D, Leiberman E, Zadik Z, Carel CA: Effect of growth hormone treatment on quality of life of short-stature children. Horm Res 1995;44:1–5.
9.
Downie AB, Mulligan J, McCaughey ES, Stratford RJ, Betts P, Voss LD: Psychological response to growth hormone treatment in short normal children. Arch Dis Child 1996;75:32–35.
10.
Ross JL, Sandberg DL, Rose SR, Leschek EW, Baron J, Chipman JJ, Cassorla FG, Quigley CA, Crowe BJ, Roberts K, Cutler GB Jr: Psychological adaptation in children with idiopathic short stature treated with growth hormone or placebo. J Clin Endocrinol Metab 2004;89:4873–4878.
11.
Leschek EW, Rose SR, Yanovski JA, Troendle JF, Quigley CA, Chipman JJ, Crowe BJ, Ross JL, Cassorla FG, Blum WF, Cutler GB Jr, Baron J: Effect of growth hormone treatment on adult height in children with non-growth-hormone-deficient short stature: a randomized, double blind, placebo-controlled trial. National Institute of Child Health and Human Development-Eli Lilly & Co. Growth Hormone Collaborative Group. J Clin Endocrinol Metab 2004;89:3140–3148.
12.
Pareren YK van, Duivenvoorden HJ, Slijper FSM, Koot HM, Hokken-Koelega ACS: Intelligence and psychosocial functioning during long-term growth therapy in children born small for gestational age. J Clin Endocrinol Metab 2004;89:5295–5302.
13.
Dennis M, Hetherington CR, Spiegler BJ: Memory and attention after childhood brain tumours. Med Pediatr Oncol 1998;30 (suppl1):25–33.
14.
Eiser, C, Vance YH, Glaser A, Galvin H, Horne B, Picton S, Stoner A, Butler G: Growth hormone treatment and quality of life among survivors of childhood cancer. Horm Res 2005;63:300–304.
15.
National Institute for Clinical Excellence: Technology Appraisal No.42. Guidance on the use of Growth Hormone (somatropin) in children with growth failure. Issue date: May 2002.
16.
Spoudeas HA: Growth and endocrine function after chemotherapy and radiotherapy in childhood. Eur J Cancer 2002;38:1748–1759.
17.
Schmiegelow MS, Lassen S, Poulsen HS, Feldt-Rasmussen U, Schmiegelow K, Hertz H, Muller J: Cranial radiotherapy of childhood brain tumours: growth hormone deficiency and its relation to the biological effective dose of irradiation in a large population based study. Clin Endocrinol 2000;53:191–197.
18.
Darzy KH, Shalet SM: Radiation-induced growth hormone deficiency. Horm Res 2003;59(suppl 1):1–11.
19.
Varni JW, Seid M, Rode CA: The PedsQLTM: measurement model for the Pediatric Quality of Life InventoryTM. Med Care 1999;37:126–139.
20.
Varni JW, Seid M, Kurtin PS: PedsQLTM: Reliability and validity of the Pediatric Quality of Life InventoryTM version 4.0 generic core scales in healthy and patient populations. Med Care 2001;39:800–812.
21.
Upton P, Eiser C, Cheung I, Hutchings H, Jenney M, Maddocks A, Russell IT, Williams JG: Measurement properties of the UK-English version of the Pediatric Quality of Life InventoryTM 4.0 (PedsQLTM) generic core scales. Health Qual Life Outcomes 2005;3:22–29.
22.
Goodman R: The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999;40:791–799.
23.
Meltzer H, Gatward R, Goodman R, Ford F: Mental health of children and adolescents in Great Britain. London, Her Majesty’s Stationary Office, 2000.
24.
Postlethwaite RJ, Reynolds JM, Wood AJ, Evans JHC, Lewis MA, Eminson DM: Recruiting patients to clinical trials: lessons from studies of growth hormone treatment in clinical trials. Arch Dis Child 1995;73:30–35.
25.
Wechsler D: Wechsler Intelligence Scale for Children, ed 3. Sidcup, Psychological Corporation, 1992.
26.
Ramsbottom R, Brewer J, Williams C: A progressive shuttle run test to estimate maximal oxygen uptake. Br J Sports Med 1988;22:141–144.
27.
Bradley J, Howard JW, Elborn S: Validity of a Modified Shuttle Test in adult cystic fibrosis. Thorax 1999;54:437–439.
28.
Bradley J, Howard JW, Elborn S: Reliability, repeatability, and sensitivity of the Modified Shuttle Test in adult cystic fibrosis. Chest 2000;117:1666–1671.
29.
Council of Europe Committee of Experts on sports research (EUROFIT): Handbook for the EUROFIT Tests on Physical Fitness, ed 2. Strasbourg, Council of Europe, 1993.
30.
Singh SJ, Morgan MD, Scott S, Walters D, Hardman AE: Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax 1992;47:1019–1024.
31.
Cole TJ, Freeman JV, Preece MA: Body-mass index reference curves for the UK, 1990. Arch Dis Child 1995;73:25–29.
32.
Lannering B, Marky I, Lundberg A, Olsson E: Long-term sequelae after pediatric brain tumors – their effect on disability and quality of life. J Med Pediatr Oncol 1990;18:304–310.
33.
Steinlin M, Imfeld S, Zulauf P, Boltshauser E, Lövblad Lüthy AR, Perrig W, Kaufmann F: Neuropsychological long-term sequelae after posterior fossa tumour resection during childhood. Brain 2003;126:1998–2008.
34.
Davies HA, Didcock E, Didi M, Ogilivy-Stuart A, Wales JKH, Shalet SM: Growth, puberty and obesity after treatment for leukaemia. Acta Pediatr Suppl 1995;411:45–50.
35.
Ramsbottom R, Brewer J, Williams C: A progressive shuttle run test to estimate maximal oxygen uptake. Br J Sports Med 1988;22:141–144.
36.
Eiser C, Morse R: The measurement of quality of life in children: past and future perspectives. Dev Behav Pediatr 2001;22:1–9.
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