43 research outputs found
Psychological effects of withdrawal of growth hormone therapy from adults with growth hormone deficiency.
Get PDFObjective: Growth hormone (GH) is known to be required for physical well-being. Whilst it is also widely believed to be important for quality of life (QoL) and psychological health, there is less supportive evidence. The objective of this study was to investigate the psychological effects of discontinuation of GH replacement from adults with severe GH deficiency (GHD).
Design: A double-blind, placebo-controlled trial in which GH replacement therapy was discontinued for 3 months from 12 of 21 GH-deficient adults, where 9 continued with GH replacement.
Patients: GH-treated adults (10 men, 11 women), all with severe GHD (peak GH
Measurements: Semi-structured interviews were given at baseline and end-point plus questionnaires that included a new hormone-deficiency specific, individualised, QoL questionnaire (HDQoL), the General Well-being Index (GWBI), the Well-being Questionnaire (W-BQ12), Short-Form 36 health status questionnaire (SF-36), the Nottingham Health Profile NHP) and the General Health Questionnaire (GHQ).
Results: Three months after baseline the serum total IGF-I of placebo-treated patients fell from normal, age related levels (mean 26.6 ± 13.2 nmol/ L) to levels indicative of severe GHD (11.6 ± 6.6 nmol/ L) (P
Conclusion: Withdrawal of GH-treatment from adults with severe GHD has detrimental psychological effects
Insulin secretion, insulin sensitivity, and hepatic insulin extraction in first-degree relatives of type 2 diabetic patients
Full text linkGlucose concentrations in parotid fluid and venous blood of patients attending a diabetic clinic.
No full textMeasurements of the glucose concentration in venous blood and parotid saliva taken from 31 diabetics attending a diabetic clinic showed values ranging respectively from 3.9 to 19.1 mmol/l and 0.06 to 0.83 mmol/l (means 9.6 mmol/l and 0.32 mmol/l respectively). Linear regression of salivary glucose on blood glucose gave a simple correlation coefficient of 0.18 (NS). Since salivary glucose levels did not reflect blood glucose levels, the possibility of diabetics regulating their metabolic control by the noninvasive technique of monitoring salivary glucose concentrations is not possible
Blood glucose control and glomerular capillary basement membrane thickening in experimental diabetes.
No full textGlomerular capillary basement membrane thickness (BMT) was measured in 23 rats which had had streptozocin-induced diabetes for 14 months and in 12 age-matched controls. Diabetic rats were randomly allocated to different groups, either receiving no treatment or treated with a low carbohydrate diet or insulin, or both. Control rats were randomly allocated to a normal or low carbohydrate diet. Among the diabetic rats mean plasma glucose concentrations for the groups ranged from 27-4 mmol/l (494 mg/100 ml) in the untreated rats to 9-8 mmol/l (177 mg/100 ml) in those receiving both a low carbohydrate diet and insulin. A highly significant positive relation was found between BMT and plasma glucose concentration for individual rats. When BMT was corrected for body weight a similar relation was observed
Effect of corticosterone on protein degradation in isolated rat soleus and extensor digitorum longus muscles.
No full textThe net catabolic effect of glucocorticoids on protein metabolism is well documented but the acute and chronic effect of glucocorticoids on protein breakdown remains controversial. In the present studies protein breakdown was measured by the release of tyrosine from the isolated soleus and extensor digitorum longus (EDL) muscles of control rats and rats treated with corticosterone (10 mg/100 g body weight/day) for 5 days. The effect of corticosterone in arresting growth was confirmed since corticosterone-treated rats weighed significantly less than control rats after 2, 3, 4 and 5 days of treatment (P < 0.001). Furthermore, the weights of soleus and EDL muscles from corticosterone-treated rats were significantly reduced (P < 0.001, at least P < 0.05 respectively) compared with muscles from control rats on days 3-5. In the EDL muscle tyrosine release was significantly elevated after corticosterone treatment for 2 days (257 +/- 21 nmol/g tissue/h, P < 0.05), 3 days (205 +/- 9 nmol/g tissue/h, P < 0.01), 4 days (255 +/- 20 nmol/g tissue/h, P < 0.005) and 5 days (218 +/- 8 nmol/g tissue/h, P < 0.05) compared with EDL from control rats (192 +/- 13, 171 +/- 7, 187 +/- 7, 180 +/- 12 nmol/g tissue/h respectively). In the soleus muscle, tyrosine release was significantly elevated after corticosterone treatment for 2 days (226 +/- 14 nmol/g tissue/h, P < 0.001), 3 days (223 +/- 16 nmol/g tissue/h, P < 0.001) and 4 days (199 +/- 10 nmol/g tissue/h, P < 0.001) compared with control rats (158 +/- 7, 132 +/- 6 and 153 +/- 7 nmol/g tissue/h respectively). After 5 days there was no significant difference in tyrosine release from soleus muscle between corticosterone-treated (176 +/- 15 nmol/g tissue/h) and control rats (157 +/- 6 nmol/g tissue/h). Plasma glucose concentrations were not significantly different in rats treated with corticosterone and control rats whilst insulin levels were significantly raised in the corticosterone-treated rats on all days compared with control rats (P < 0.05 on day 1; P < 0.001 on days 2, 3, 4 and 5). It is suggested that insulin may have prevented hyperglycaemia developing in the corticosterone-treated rats. Results from these studies indicate that the acute effect of glucocorticoids is to increase muscle proteolysis but this is not maintained with longer-term treatment
Psychometric evaluation of an individualised measure of men’s perceived impact of age-related decline in hormone levels on their quality of life (QoL): the A-RHDQoL
Get PDFPsychometric properties of two measures of psychological well-being in adult growth hormone deficiency.
No full textBACKGROUND: Psychometric properties of two measures of psychological well-being were evaluated for adults with growth hormone deficiency (GHD): the General Well-being Index, (GWBI)--British version of the Psychological General Well-being Index, and the 12-item Well-being Questionnaire (W-BQ12). METHODS: Reliability, structure and other aspects of validity were investigated in a cross-sectional study of 157 adults with treated or untreated GHD, and sensitivity to change in a randomised placebo-controlled study of three months' growth hormone (GH) withdrawal from 12 of 21 GH-treated adults. RESULTS: Very high completion rates were evidence that both questionnaires were acceptable to respondents. Factor analyses did not indicate the existence of useful GWBI subscales, but confirmed the validity of calculating a GWBI Total score. However, very high internal consistency reliability (Cronbach's alpha = 0.96, N = 152), probably indicated some item redundancy in the 22-item GWBI. On the other hand, factor analyses confirmed the validity of the three W-BQ12 subscales of Negative Well-being, Energy, and Positive Well-being, each having excellent internal reliability (alphas of 0.86, 0.86 and 0.88, respectively, N from 152 to 154). There was no sign of item redundancy in the highly acceptable Cronbach's alpha of 0.93 (N = 148) for the whole W-BQ12 scale. Whilst neither questionnaire found significant differences between GH-treated and non-GH-treated patients, there were correlations (for GH-treated patients) with duration of GH treatment for GWBI Total (r = -0.36, p = 0.001, N = 85), W-BQ12 Total (r = 0.35, p = 0.001, N = 88) and for all W-BQ12 subscales: thus the longer the duration of GH treatment (ranging from 0.5 to 10 years), the better the well-being. Both questionnaires found that men had significantly better overall well-being than women. The W-BQ12 was more sensitive to change than the GWBI in the GH-Withdrawal study. A significant between-group difference in change in W-BQ12 Energy scores was found [t(18) = 3.25, p = 0.004, 2-tailed]: patients withdrawn from GH had reduced energy at end-point. The GWBI found no significant change. CONCLUSION: The W-BQ12 is recommended in preference to the GWBI to measure well-being in adult GHD: it is considerably shorter, has three useful subscales, and has greater sensitivity to change
Preliminary development of a new individualised questionnaire measuring quality of life in older men with age-related hormonal decline: the A-RHDQoL
Get PDFThere is increasing interest in hormone replacement therapy to improve health and quality of life (QoL) of older men with age-related decline in hormone levels. This paper reports the preliminary development and evaluation of the psychometric properties of a new individualised questionnaire, the A-RHDQoL, measuring perceived impact of age-related hormonal decline on QoL of older men. A-RHDQoL design was based on the HDQoL for people with growth hormone (GH) deficiency and the ADDQoL (for diabetes)
