The Effects of Growth Hormone Replacement Therapy on Bone Metabolism in Adult-Onset Growth Hormone Deficiency: A 2-Year Open Randomized Controlled Multicenter Trial
| Autor: | Roger Bouillon, Roger Abs, G. Lamberigts, Dominique Maiter, Marie Bex, Albert Beckers |
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| Přispěvatelé: | UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - MD/MINT - Département de médecine interne |
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Bone density Growth hormone therapy Endocrinology Diabetes and Metabolism Bone and Bones - metabolism Bone and Bones Growth hormone deficiency Bone remodeling Absorptiometry Photon Bone Density Multicenter trial Internal medicine medicine Humans Orthopedics and Sports Medicine Age of Onset Insulin-Like Growth Factor I Completely randomized design Aged Bone mineral biology business.industry Middle Aged medicine.disease Insulin-Like Growth Factor Binding Protein 3 - blood Insulin-Like Growth Factor Binding Protein 3 Endocrinology Insulin-Like Growth Factor I - metabolism Growth Hormone - administration & dosage deficiency Growth Hormone Osteocalcin biology.protein Patient Compliance Female Age of onset business Controlled study |
| Zdroj: | Journal of Bone and Mineral Research, Vol. 17, no. 6, p. 1081-1094 (2002) |
| ISSN: | 0884-0431 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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