Effect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2-year randomized, controlled, dose-ranging study.

2.50
Hdl Handle:
http://hdl.handle.net/10541/79037
Title:
Effect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2-year randomized, controlled, dose-ranging study.
Authors:
Shalet, Stephen M; Shavrikova, Elena; Cromer, Morris; Child, Christopher J; Keller, Eberhard; Zapletalová, Jirina; Moshang, Thomas; Blum, Werner F; Chipman, John J; Quigley, Charmian A; Attanasio, Andrea F
Abstract:
GH treatment in children with GH deficiency is frequently terminated at final height. However, in healthy individuals bone mass continues to accrue until peak bone mass is achieved. Because no prospective data specifically prove the role of GH in attainment of peak bone mass, we performed a multinational, controlled, 2-yr study in patients who had terminated pediatric GH at final height. Patients were randomized to: GH at 25.0 microg/kg x day (pediatric dose, n = 58) or 12.5 microg/kg x day (adult dose, n = 59), or no GH treatment (control, n = 32). Bone mineral content (BMC) and density were measured by dual-energy x-ray absorptiometry and evaluated centrally. Laboratory measurements were also performed centrally. After 2 yr, significant increases were seen with both GH treatments, compared with control in bone-specific alkaline phosphatase (P = 0.004) and type I collagen C-terminal telopeptide:creatinine ratio (P < 0.001), but there were no significant dose effects. Total BMC increased by 9.5 +/- 8.4% in the adult dose group, 8.1 +/- 7.6% in the pediatric dose group, and 5.6 +/- 8.4% in controls (analysis of covariance, P = 0.008), with no significant GH dose effect. BMC increased predominantly at the lumbar spine (11.0 +/- 10.6%, P = 0.015) rather than at the femoral neck or hip. In contrast, a significant dose-dependent increase was seen in IGF-I concentrations (adult dose: 114.5 +/- 119.4 microg/liter; pediatric dose: 178.5 +/- 143.7 microg/liter; P = 0.023). There were no gender-related differences in BMC changes with either dose, whereas the IGF-I increase was significantly higher with the pediatric than with the adult dose in females (P < 0.001) but not males (P = 0.606). In summary, reinstitution of GH replacement after final height in severely GH-deficient patients induced significant progression toward peak bone mass. Although there was a by-gender dose effect on IGF-I concentration, the treatment effect on bone was obtained in both males and females with the adult GH dose regimen.
Affiliation:
Department of Endocrinology, Christie Hospital NHS Trust, Manchester M20 4BX, United Kingdom. stephen.m.shalet@man.ac.uk
Citation:
Effect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2-year randomized, controlled, dose-ranging study. 2003, 88 (9):4124-9 J. Clin. Endocrinol. Metab.
Journal:
The Journal of Clinical Endocrinology and Metabolism
Issue Date:
Sep-2003
URI:
http://hdl.handle.net/10541/79037
DOI:
10.1210/jc.2003-030126
PubMed ID:
12970274
Type:
Article
Language:
en
ISSN:
0021-972X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorShalet, Stephen M-
dc.contributor.authorShavrikova, Elena-
dc.contributor.authorCromer, Morris-
dc.contributor.authorChild, Christopher J-
dc.contributor.authorKeller, Eberhard-
dc.contributor.authorZapletalová, Jirina-
dc.contributor.authorMoshang, Thomas-
dc.contributor.authorBlum, Werner F-
dc.contributor.authorChipman, John J-
dc.contributor.authorQuigley, Charmian A-
dc.contributor.authorAttanasio, Andrea F-
dc.date.accessioned2009-08-28T09:03:36Z-
dc.date.available2009-08-28T09:03:36Z-
dc.date.issued2003-09-
dc.identifier.citationEffect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2-year randomized, controlled, dose-ranging study. 2003, 88 (9):4124-9 J. Clin. Endocrinol. Metab.en
dc.identifier.issn0021-972X-
dc.identifier.pmid12970274-
dc.identifier.doi10.1210/jc.2003-030126-
dc.identifier.urihttp://hdl.handle.net/10541/79037-
dc.description.abstractGH treatment in children with GH deficiency is frequently terminated at final height. However, in healthy individuals bone mass continues to accrue until peak bone mass is achieved. Because no prospective data specifically prove the role of GH in attainment of peak bone mass, we performed a multinational, controlled, 2-yr study in patients who had terminated pediatric GH at final height. Patients were randomized to: GH at 25.0 microg/kg x day (pediatric dose, n = 58) or 12.5 microg/kg x day (adult dose, n = 59), or no GH treatment (control, n = 32). Bone mineral content (BMC) and density were measured by dual-energy x-ray absorptiometry and evaluated centrally. Laboratory measurements were also performed centrally. After 2 yr, significant increases were seen with both GH treatments, compared with control in bone-specific alkaline phosphatase (P = 0.004) and type I collagen C-terminal telopeptide:creatinine ratio (P < 0.001), but there were no significant dose effects. Total BMC increased by 9.5 +/- 8.4% in the adult dose group, 8.1 +/- 7.6% in the pediatric dose group, and 5.6 +/- 8.4% in controls (analysis of covariance, P = 0.008), with no significant GH dose effect. BMC increased predominantly at the lumbar spine (11.0 +/- 10.6%, P = 0.015) rather than at the femoral neck or hip. In contrast, a significant dose-dependent increase was seen in IGF-I concentrations (adult dose: 114.5 +/- 119.4 microg/liter; pediatric dose: 178.5 +/- 143.7 microg/liter; P = 0.023). There were no gender-related differences in BMC changes with either dose, whereas the IGF-I increase was significantly higher with the pediatric than with the adult dose in females (P < 0.001) but not males (P = 0.606). In summary, reinstitution of GH replacement after final height in severely GH-deficient patients induced significant progression toward peak bone mass. Although there was a by-gender dose effect on IGF-I concentration, the treatment effect on bone was obtained in both males and females with the adult GH dose regimen.en
dc.language.isoenen
dc.subject.meshAbsorptiometry, Photon-
dc.subject.meshAdult-
dc.subject.meshAlkaline Phosphatase-
dc.subject.meshBody Height-
dc.subject.meshBone Density-
dc.subject.meshBone Development-
dc.subject.meshBone and Bones-
dc.subject.meshCalcification, Physiologic-
dc.subject.meshCohort Studies-
dc.subject.meshCollagen Type I-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshDouble-Blind Method-
dc.subject.meshFemale-
dc.subject.meshGrowth Hormone-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshProspective Studies-
dc.subject.meshPuberty-
dc.subject.meshSex Characteristics-
dc.titleEffect of growth hormone (GH) treatment on bone in postpubertal GH-deficient patients: a 2-year randomized, controlled, dose-ranging study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital NHS Trust, Manchester M20 4BX, United Kingdom. stephen.m.shalet@man.ac.uken
dc.identifier.journalThe Journal of Clinical Endocrinology and Metabolismen

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