Bone status and fracture prevalence in Russian adults with childhood-onset growth hormone deficiency
| Autor: | Olga Bezlepkina, Roger Bouillon, O. Chikulaeva, E. Nagaeva, J. Nijs, A. Bakulin, E. Shavrikhova, Valentina Peterkova, E. Koledova, Andrea F. Attanasio, V. Oganov, Ivan Ivanovich Dedov |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Bone density Endocrinology Diabetes and Metabolism Clinical Biochemistry Biochemistry Bone and Bones Growth hormone deficiency Russia Fractures Bone Endocrinology Bone Density Risk Factors Internal medicine Prevalence Medicine Humans Age of Onset Child Dwarfism Pituitary Femoral neck Bone mineral business.industry Incidence (epidemiology) Incidence Biochemistry (medical) Odds ratio Middle Aged medicine.disease medicine.anatomical_structure IGHD Female Age of onset business |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 89(10) |
| ISSN: | 0021-972X |
| Popis: | The consequences of lifelong untreated childhood-onset GH deficiency (COGHD) on adult bone and especially fracture prevalence are largely unknown due to the lack of data on long-term outcome of untreated patients. Therefore, we studied adult Russian patients (n = 66; 28 females and 38 males) with idiopathic GH-untreated COGHD. Patients had isolated GH deficiency (IGHD; n = 18, age 23 +/- 10 yr) or multiple pituitary hormone deficiency (MPHD) with open (OMPHD; n = 27, age 23 +/- 5 yr) or closed growth plates (CMPHD; n = 21, age 55 +/- 12 yr). Bone mineral content (BMC) and bone mineral density (BMD) values were compared with 821 normal Russian controls. Fracture prevalence was ascertained from medical history and compared with similar data from 333 normal controls. Height sd score was -4.6 (range, -1.8 to -8.1). This represents 82% of the height of normal Russian adults. BMC of the lumbar spine, femoral neck, and total body of patients with IGHD was 54, 71, and 59%, respectively, of that of age- and sex-matched controls (all P < 0 0.001). A similarly decreased BMC (42-69% of expected values) was found for all bone regions of patients with both OMPHD and CMPHD. Mean areal BMD measurements (g/cm(2)) varied (Z scores between -1.8 and -3.0), but the calculated true bone density (g/cm(3)) was normal in patients with IGHD or CMPHD and only slightly decreased (Z score, -0.8) in patients with OMPHD. Lifetime low-energy fracture prevalence was normal in patients with IGHD but substantially exceeded the expected prevalence in OMPHD (odds ratio of fracture = 3.0; 0.6 fractures per patient; P < 0.0001) or CMPHD patients (odds ratio for fracture = 7.4; 2.2 fractures per patient; P < 0.0001). In conclusion, IGHD and MPHD of childhood onset very substantially impair adult height and BMC. Although areal BMD is frankly decreased, volumetric bone density is unaffected, but nevertheless, the fracture prevalence in patients with MPHD is markedly increased. These observations demonstrate that not only volumetric density but also bone mass and shape are major determinants of bone strength. |
| Databáze: | OpenAIRE |
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