Two Years of Growth Hormone (GH) Treatment Increases Mineral Content and Density in Hypopituitary Patients with Adult-Onset GH Deficiency
The main purpose of this trial was to determine the effects of two years of GH treatment on bone mineral density (BMD) and bone metabolism in patients with adult-onset GH deficiency. Forty-four patients (24 men and 20 women; aged 23-66 yr) participated in a two year open treatment trial with recombinant human GH. BMD was assessed with dual energy x-ray absorptiometry, and serum concentrations of osteocalcin, carboxy-terminal propeptide of type 1 procollagen (PICP) and carboxy-terminal cross-linked telopeptide of type 1 collagen (ICTP) were measured. After two years of GH treatment, the BMD increased in the lumbar spine L2-L4 by 3.8% [95% confidence interval (CI), 2.1-5.5], in the femoral neck by 4.1% (CI, 2.1-6.1), in the femoral trochanter by 5.6% (CI, 3.8-7.4), and in Ward’s triangle by 4.9% (CI, 2.2-7.6) compared with baseline. Patients with a z-score (difference in SD from the mean of age- and sex-matched subjects) below -1 SD responded with the most marked BMD increment. The serum concentrations of osteocalcin, PICP, and ICTP remained higher throughout the two years of treatment. Women demonstrated a more marked increase in total body BMD and a less pronounced initial increment in osteocalcin, PICP, and ICTP than men.
Two years of GH treatment induced a sustained increase in overall bone remodeling activity, which resulted in a net gain in BMD that was more marked in those subjects with a low pretreatment z-score.
The Journal of Clinical Endocrinology & Metabolism
Gudmundur Johannsson, Thord Rosen, Ingvar Bosaeus,
Lars Sjostrom, and Bengt-Ake Bengtsson 1996, Vol.81, No. 8
