The effects of growth hormone replacement therapy on bone metabolism in adult-onset growth hormone deficiency: A 2-year open randomized controlled multicenter trial
Bex, M.; Abs, R.; Maiter, D.et al.
2002 • In Journal of Bone and Mineral Research, 17 (6), p. 1081-1094
The effects of growth hormone replacement therapy on bone metabolism in adult-onset growth hormone deficiency - A 2-year open randomized controlled multicenter trial.pdf
adult; growth hormone deficiency; bone density; growth hormone therapy; controlled study
Abstract :
[en] Adult hypopituitary patients with growth hormone deficiency (GHD) show a significant decrease in bone mass and an increased fracture rate. Replacement therapy with GH increases bone turnover. Most of the long-term data on bone mineral content (BMC) and bone mineral density (BMD) have been acquired in open, noncontrolled trials involving limited numbers of patients. To determine whether long-term GH therapy is beneficial for bone despite the increased bone turnover, 100 patients (59 men and 41 women), aged 25-65 years (mean, 49.7 years) with adult-onset GHD were randomized to treatment with GH (40 men and 28 women; mean dose, 0.18 IU/kg per week) or to a nontreated control group (19 men and 13 women) for 24 months. Despite a similar increase in parameters of bone turnover (osteocalcin [OC], procollagen type I carboxy-terminal propeptide [PICP], and pyridinolines ([PYD]) in male and female GH-treated patients compared with controls, the effects on BMC and BMD as evaluated by dual-energy X-ray absorptiometry were gender specific. A significant increase in spine BMC and BMD and total hip BMD and a decrease in BMD at the ultradistal radius over time was observed in male GH-treated patients compared with the evolution in controls (mean +/- SEM change at 24 months: + 6.8 +/- 1.1% and p = 0.009, +5.1 +/- 0.8% and p = 0.005, +3.5 +/- 0.7% and p = 0.02, and -2.6 +/- 0.8% and p = 0.008, respectively). No significant treatment effects were observed in female patients. Despite the increase in the total remodeling space induced by GH treatment, prolonged GH therapy in adult-onset GHD has a positive effect on bone balance, maintaining bone mass in women, and even increasing it in men over a 2 year-period.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Bex, M.
Abs, R.
Maiter, D.
Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Lamberigts, G.
Bouillon, R.
Language :
English
Title :
The effects of growth hormone replacement therapy on bone metabolism in adult-onset growth hormone deficiency: A 2-year open randomized controlled multicenter trial
Publication date :
June 2002
Journal title :
Journal of Bone and Mineral Research
ISSN :
0884-0431
eISSN :
1523-4681
Publisher :
American Society for Bone and Mineral Research, Washington, United States - District of Columbia
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