Key result
Long-term growth hormone treatment significantly improved radial and lumbar bone mineral density Z-scores in children with GH deficiency (P<0.001).
Why the study?
Does growth hormone treatment improve bone mineral density in children with GH deficiency?
Observational (n=60)
Does growth hormone treatment improve bone mineral density in children with GH deficiency?
p-value: p=<0.001
Optimal growth hormone treatment improves bone mineral density in children with GH deficiency, highlighting the importance of continuing therapy until peak bone mass is attained.
Long-term GH may raise BMD Z-scores in GHD youth; leaves open whether continuous therapy optimizes peak bone mass.
The effect of long-term GH treatment on bone mass was examined in 32 children with GH deficiency (GHD) aged 7.2-16.3 yr by measuring radial (distal third, single-photon absorptiometry) and lumbar (L2-L4, dual energy x-ray absorptiometry) bone mineral density (BMD) (group A). All patients were longitudinally followed and received recombinant hGH therapy for a mean period of 48.2 +/- 13.2 months. BMD values were corrected for bone age and expressed as Z-score in comparison with normative data. In addition, lumbar BMD and lumbar BMD corrected for the estimated vertebral volumes were assessed in 11 patients with GHD aged 16.0 - 18.7 yr at the time they reached their final height (group B) and, in 17 subjects with familial short stature aged 16.4 - 19.8 yr, as controls (group C) for patients of group B. Patients of group B had received discontinuous treatment with pituitary-derived hGH and subsequently recombinant hGH (total duration of treatment 151.5 +/- 9.7 months). The off-treatment period was 4.7 +/- 2.6 months. Before treatment, patients of group A showed significantly reduced (P < 0.001) radial and lumbar BMD (-1.7 +/- 0.4 Z-score and -1.5 +/- 0.5 Z-score, respectively) compared with normative data. During treatment, radial and lumbar BMD Z-scores improved significantly (P < 0.001); in the patients treated for the longest time, the BMD was within 0.5 SD of age-matched mean levels. In patients of group B, lumbar BMD and lumbar BMD corrected for the estimated vertebral volumes were significantly reduced in comparison with subjects of group C (-1.2 +/- 0.4 Z-score and -1.0 +/- 0.4 Z-score, P < 0.01 and P < 0.03, respectively). The results show that children with GHD have reduced BMD. Optimal GH treatment improves BMD, whereas inappropriate treatment is a main cause of reduced BMD at time of final height. These findings suggest an important role of GH therapy in the attainment of peak bone mass in children with GHD. GH treatment should be continued until the attainment of peak bone mass irrespective of the height achieved.
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Saggese et al. (1996) conducted an observational in Growth hormone deficiency (n=60). Growth hormone (GH) treatment vs. Normative data and subjects with familial short stature was evaluated on Radial and lumbar bone mineral density (BMD) Z-scores (p=<0.001). Long-term growth hormone treatment significantly improved radial and lumbar bone mineral density Z-scores in children with GH deficiency (P<0.001).
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