Effect of low-normal and high-normal IGF-1 levels on memory and wellbeing during growth hormone replacement therapy: A randomized clinical trial in adult growth hormone deficiency

Christa C. van Bunderen*, Jan Berend Deijen, Madeleine L. Drent

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND:
The aim of the present study was to investigate the effect of low-normal and high-normal levels of IGF-1 in growth hormone (GH) deficient adults on cognition and wellbeing during GH treatment.

METHODS:
A randomized, open-label, clinical trial including 32 subjects receiving GH therapy for at least 1 year. Subjects were randomized to receive either a decrease (IGF-1 target level of - 2 to - 1 SDS) or an increase of their daily GH dose (IGF-1 target level of 1 to 2 SDS) for a period of 24 weeks. Memory was measured by the Cambridge Neuropsychological Test Automated Battery, selecting the Pattern Recognition Memory task and the Spatial Working Memory. Wellbeing was measured as mood by the Profile of Moods States questionnaire, and quality of life by the Nottingham Health Profile and QoL Assessment in GH Deficiency in Adults questionnaires.

RESULTS:
Data from 30 subjects (65.6% male, mean age 46.6 (9.9 SD) years), who fulfilled the target levels, were analyzed. Females in the low dose treatment arm were found to have a better working memory and a better strategic memory control after 24 weeks as opposed to the females in the high treatment arm. With respect to mood, the decrease in IGF-1 levels in females within the low treatment arm was associated with more fatigue and less vigor.

CONCLUSIONS:
The adjustment of GH dose in female patients seems to have a narrow window. A dose too high may impair prefrontal cognitive functioning, while a dose too low may result in decreased vigor.
Original languageEnglish
Article number135
Pages (from-to)1-10
Number of pages10
JournalHealth and Quality of Life Outcomes
Volume16
DOIs
Publication statusPublished - 6 Jul 2018

Funding

CCVB is supported by an AGIKO grant of The Netherlands Organisation for Health Research and Development (ZonMw) (grant number: 92003591). This work was partly supported by an investigator-initiated grant from Pfizer bv. The funding sources had no involvement in study design, collection, analysis and interpretation of data, writing of the report, and in the decision to submit the article for publication.

FundersFunder number
Pfizer Pharmaceuticals
ZonMw92003591

    Keywords

    • Cognition
    • Growth hormone deficiency
    • Growth hormone treatment
    • Insulin-like growth factor-1
    • Memory
    • Mood

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