Effect of growth hormone replacement on bone mass in adults with adult onset growth hormone deficiency.
dc.contributor.author | Holmes, Sarah J | |
dc.contributor.author | Whitehouse, R W | |
dc.contributor.author | Swindell, Ric | |
dc.contributor.author | Economou, G | |
dc.contributor.author | Adams, J E | |
dc.contributor.author | Shalet, Stephen M | |
dc.date.accessioned | 2010-05-10T16:25:22Z | |
dc.date.available | 2010-05-10T16:25:22Z | |
dc.date.issued | 1995-06 | |
dc.identifier.citation | Effect of growth hormone replacement on bone mass in adults with adult onset growth hormone deficiency. 1995, 42 (6):627-33 Clin. Endocrinol | en |
dc.identifier.issn | 0300-0664 | |
dc.identifier.pmid | 7634504 | |
dc.identifier.doi | 10.1111/j.1365-2265.1995.tb02690.x | |
dc.identifier.uri | http://hdl.handle.net/10541/98400 | |
dc.description.abstract | OBJECTIVE: Previous studies of the effect of GH replacement on bone mass in adults with GH deficiency have produced conflicting results. We have studied the effect of 6 and 12 months of GH replacement on bone mass in adults with adult onset GH deficiency. DESIGN: Double blind placebo controlled study of GH replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) for 6 months and an open study for a further 6 or 12 months. PATIENTS: Twenty-two adults (10 men, 12 women), aged 41.5 +/- 2.1 years (mean +/- SE, range 23.6-59.5), with adult onset GH deficiency. MEASUREMENTS: Single-energy quantitative computed tomography was used to measure vertebral trabecular bone mineral density (BMD), single-photon absorptiometry (SPA) was used to measure forearm cortical and integral bone mineral content and BMD and dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine, femoral neck, trochanteric and Ward's triangle integral BMD. RESULTS: After 6 months of GH replacement (n = 21) there was a significant decrease in forearm cortical BMD (SPA: median change -0.009 g/cm2, P = 0.01), forearm integral BMD (SPA: median change -0.016 g/cm2, P = 0.03), lumbar spine BMD (DXA: median change -0.22 g/cm2; P = 0.003) and femoral neck BMD (DXA: median change -0.029 g/cm2, P = 0.006). After 12 months of GH replacement (n = 13) there was a significant decrease in lumbar spine BMD (DXA: median change -0.035 g/cm2, P = 0.002) from baseline. There was no significant increase in bone mass at any site after 6 or 12 months of GH replacement. Change in bone mass was not influenced by sex of the patient or by presence or absence of additional pituitary hormone deficiencies. CONCLUSION: The response of bone mass to 6 and 12 months of GH replacement in adults with adult onset GH deficiency is disappointing. Longer-term studies are required to determine whether prolonged GH replacement has a beneficial effect on bone mass. | |
dc.language.iso | en | en |
dc.subject.mesh | Adult | |
dc.subject.mesh | Bone Density | |
dc.subject.mesh | Double-Blind Method | |
dc.subject.mesh | Female | |
dc.subject.mesh | Femur Neck | |
dc.subject.mesh | Forearm | |
dc.subject.mesh | Growth Hormone | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Lumbar Vertebrae | |
dc.subject.mesh | Male | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Time Factors | |
dc.title | Effect of growth hormone replacement on bone mass in adults with adult onset growth hormone deficiency. | en |
dc.type | Article | en |
dc.contributor.department | Department of Endocrinology, Christie Hospital NHS Trust, Manchester, UK. | en |
dc.identifier.journal | Clinical Endocrinology | en |
html.description.abstract | OBJECTIVE: Previous studies of the effect of GH replacement on bone mass in adults with GH deficiency have produced conflicting results. We have studied the effect of 6 and 12 months of GH replacement on bone mass in adults with adult onset GH deficiency. DESIGN: Double blind placebo controlled study of GH replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) for 6 months and an open study for a further 6 or 12 months. PATIENTS: Twenty-two adults (10 men, 12 women), aged 41.5 +/- 2.1 years (mean +/- SE, range 23.6-59.5), with adult onset GH deficiency. MEASUREMENTS: Single-energy quantitative computed tomography was used to measure vertebral trabecular bone mineral density (BMD), single-photon absorptiometry (SPA) was used to measure forearm cortical and integral bone mineral content and BMD and dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine, femoral neck, trochanteric and Ward's triangle integral BMD. RESULTS: After 6 months of GH replacement (n = 21) there was a significant decrease in forearm cortical BMD (SPA: median change -0.009 g/cm2, P = 0.01), forearm integral BMD (SPA: median change -0.016 g/cm2, P = 0.03), lumbar spine BMD (DXA: median change -0.22 g/cm2; P = 0.003) and femoral neck BMD (DXA: median change -0.029 g/cm2, P = 0.006). After 12 months of GH replacement (n = 13) there was a significant decrease in lumbar spine BMD (DXA: median change -0.035 g/cm2, P = 0.002) from baseline. There was no significant increase in bone mass at any site after 6 or 12 months of GH replacement. Change in bone mass was not influenced by sex of the patient or by presence or absence of additional pituitary hormone deficiencies. CONCLUSION: The response of bone mass to 6 and 12 months of GH replacement in adults with adult onset GH deficiency is disappointing. Longer-term studies are required to determine whether prolonged GH replacement has a beneficial effect on bone mass. |