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Reis CT, Macedo MC, Morcillo AM, Guerra G, de Lemos-Marini SHV. Anthropometry and physical appearance can be associated with quality of life in Brazilian women with Turner syndrome. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:126-135. [PMID: 36468921 PMCID: PMC9983798 DOI: 10.20945/2359-3997000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective This study aimed to analyze if anthropometric factors and physical appearance are associated to QoL in Turner syndrome (TS). Materials and methods Observational, analytical, and cross-sectional study. The SF-36 was applied along with an additional questionnaire regarding specific characteristics of TS. Results There were no differences in quality of life (QoL) in TS women regarding median height and appropriate height according to parental target height, however, participants satisfied and who did not desire to change their height had better scores in the mental health and role emotional domains than those not satisfied and desired to change it. When comparing participants who were or were not bothered by physical appearance, the results showed that those not bothered by physical appearance had a better score in the vitality and social function domains. Considering patients who did or did not desire to change physical appearance, those who did not want to change their physical appearance had higher scores in the mental component and in the social function and mental health domains of the SF-36. Conclusion This study indicated that anthropometric factors and physical appearance may possibly be associated to QoL in TS, and also emphasizes the need to develop and validate an official questionnaire regarding specific TS characteristics in order to assess in more detail how specific characteristics of TS interfere with their QoL.
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Affiliation(s)
| | | | | | - Gil Guerra
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil
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Ajmal A, McKean E, Sullivan S, Barkan A. Decreased quality of life (QoL) in hypopituitary patients: involvement of glucocorticoid replacement and radiation therapy. Pituitary 2018; 21:624-630. [PMID: 30349995 DOI: 10.1007/s11102-018-0918-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE Hypopituitary patients are assumed to have decreased QoL due to GHD. However, in placebo controlled trials, the effects of GH replacement are no different from placebo. Hydrocortisone dose > 20 mg/day and pituitary radiation are independently associated with poorer QoL. We assessed QoL in panhypopituitary GH- deficient patients never treated with GH. METHODS Study group was divided into: (a) surgery followed by radiation (n = 21) and (b) surgery alone (n = 32). Mean duration of GHD was 71.4 ± 7.8 months and mean daily hydrocortisone dose was 15 ± 0.7 mg. Control group had transnasal surgery for benign sinus conditions (n = 54). RESULTS AGHDA scores were significantly worse in the entire study group compared to controls (8.1 ± 1.0 vs. 5.1 ± 0.9, p = 0.03). In patients with history of radiation therapy AGHDA scores were significantly worse than in controls (9.1 ± 1.5, p = 0.02) and SNOT-22 (Sino-Nasal Outcome Test) scores were also significantly worse (15.8 ± 2.0 vs. 23.2 ± 3.5, p = 0.04). However, AGHDA scores in patients without history of radiation and on "physiological" dose of hydrocortisone were similar to those in controls (5.1 ± 0.9 vs. 7.3 ± 1.3, p = 0.17). CONCLUSIONS Replacement with hydrocortisone doses not exceeding 20 mg/day and avoidance of radiation therapy was accompanied by normal QoL in patients not replaced with GH. Thus, we suggest that the decreased QoL in hypopituitary patients may not be due to GH deficiency per se, but rather to high hydrocortisone doses and to aftereffects of cranial radiation.
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Affiliation(s)
- Adnan Ajmal
- Division of Metabolism, Endocrinology and Diabetes, Department of Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, G-1500, Ann Arbor, MI, 48106, USA
| | - Erin McKean
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Stephen Sullivan
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Ariel Barkan
- Division of Metabolism, Endocrinology and Diabetes, Department of Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, G-1500, Ann Arbor, MI, 48106, USA.
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
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Gardner CJ, Mattsson AF, Daousi C, Korbonits M, Koltowska-Haggstrom M, Cuthbertson DJ. GH deficiency after traumatic brain injury: improvement in quality of life with GH therapy: analysis of the KIMS database. Eur J Endocrinol 2015; 172:371-81. [PMID: 25583905 DOI: 10.1530/eje-14-0654] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Prevalence of GH deficiency (GHD) caused by traumatic brain injury (TBI) is highly variable. Short-term studies show improvement in quality of life (QoL) during GH replacement (GHR), but long-term data are lacking. The aim of this study was to analyse the clinical characteristics of post-traumatic hypopituitarism and the QoL effects of long-term GHR. DESIGN/METHODS Pfizer International Metabolic Database patients with GHD caused by TBI and by non-functioning pituitary adenoma (NFPA) were compared regarding: clinical characteristics at baseline and 1-year of GHR, and QoL response up to 8-years of GHR (QoL-AGHDA total scores and dimensions) in relationship with country-specific norms. RESULTS TBI patients compared with NFPA patients were younger, diagnosed with GHD 2.4 years later after primary disease onset (P<0.0001), had a higher incidence of isolated GHD, higher GH peak, a more favourable metabolic profile and worse QoL, were shorter by 0.9 cm (1.8 cm when corrected for age and gender; P=0.004) and received higher GH dose (mean difference: 0.04 mg/day P=0.006). In TBI patients, 1-year improvement in QoL was greater than in NFPA (change in QoL-AGHDA score 5.0 vs 3.5, respectively, P=0.04) and was sustained over 8 years. In TBI patients, socialisation normalised after 1 year of GHR, self-confidence and tenseness after 6 years and no normalisation of tiredness and memory was observed. CONCLUSION Compared with NFPA, TBI patients presented biochemically with less severe hypopituitarism and worse QoL scores. GHR achieved clinically relevant, long-term benefit in QoL.
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Affiliation(s)
- Chris J Gardner
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
| | - Anders F Mattsson
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
| | - Christina Daousi
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
| | - Márta Korbonits
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
| | - Maria Koltowska-Haggstrom
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
| | - Daniel J Cuthbertson
- Department of Obesity and EndocrinologyInstitute of Ageing and Chronic Disease, University of Liverpool, Liverpool L9 7AL, UKPfizer Endocrine CarePfizer, Inc., Sollentuna, SwedenBarts and the London School of Medicine and DentistryWilliam Harvey Research Institute, Centre for Endocrinology, Queen Mary University of London, London, UKDepartment of Women's and Children's HealthUppsala University, Uppsala, Sweden
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