Aspects of growth hormone (GH) replacement in elderly patients with GH deficiency: data from KIMS

This study was designed to examine the clinical characteristics of adult-onset growth hormone deficiency (AO-GHD) in patients aged over 65 years in comparison with patients aged less than 65 years. In addition, the effects of 12 months of GH replacement therapy on body composition, carbohydrate metabolism, blood pressure, serum lipids and quality of life were compared between patients aged over 65 years and patients under 45 years, 45-55 years and 55-65 years of age. The investigation was an observational study of patients enrolled in KIMS (Pharmacia International Metabolic Database). Baseline clinical characteristics were qualitatively similar, and scores from the Assessment of Quality of Life in GH-deficient Adults questionnaire (QoL-AGHDA) were indistinguishable between patients aged over 65 years and younger patients. Improvements in QoL-AGHDA scores were similar in all age groups during GH replacement therapy. Significant reductions in total and low-density lipoprotein cholesterol levels were observed in all groups and tended to be greater in patients aged over 65 years. Waist circumference and waist:hip ratio were not influenced by GH replacement therapy in women aged over 65 years, which was in contrast to the reductions observed in younger male and female patients and the decrease in waist circumference observed in men aged over 65 years. The similarities and differences in response to GH replacement therapy between patients aged over 65 years and those aged less than 65 years remained evident when the latter group was stratified by age. In conclusion, older patients with AO-GHD who receive GH replacement therapy achieve beneficial effects equivalent to those seen in younger patients in all age groups and require lower doses of GH.