1. The Effects of Growth Hormone Replacement Therapy on Bone Metabolism in Adult-Onset Growth Hormone Deficiency: A 2-Year Open Randomized Controlled Multicenter Trial
- Author
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Roger Bouillon, Roger Abs, G. Lamberigts, Dominique Maiter, Marie Bex, Albert Beckers, UCL - (SLuc) Service d'endocrinologie et de nutrition, and UCL - MD/MINT - Département de médecine interne
- Subjects
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 - Abstract
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.
- Published
- 2002
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