BONE-MINERAL STATUS IN GROWTH HORMONE-DEFICIENT MALES WITH ISOLATED AND MULTIPLE PITUITARY DEFICIENCIES OF CHILDHOOD ONSET

被引:293
作者
KAUFMAN, JM
TAELMAN, P
VERMEULEN, A
VANDEWEGHE, M
机构
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D O I
10.1210/jc.74.1.118
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In order to determine whether growth hormone (GH) deficiency of childhood onset affects the adult bone mineral status, we assessed bone mineral content (BMC) by photon absorptiometry in 30 full-grown GH-deficient men (8 with isolated GH deficiency and 22 with multiple pituitary deficiencies; 28 previously treated with GH) and in 30 male controls matched for age (within 4 yr) and height (within 10 cm). Forearm BMC was measured by single photon absorptiometry just proximally of the distal one third of the nondominant forearm (PBMC-2 in arbitrary units and PBMC/bone width (BW) after normalization for bone width) and at a more distal site, close to the carpal joint (DBMC-2 and DBMC/BW). Lumbar BMC was measured by dual photon absorptiometry and reported as total BMC for L2-L4 (LBMC in g) and after normalization for projected area (LBMD in g/cm2). The patients had a significantly lower BMC, both at the forearm (P < 0.0001) and at the lumbar spine (P < 0.005): 35.7 +/- 1.0 vs. 50.0 +/- 1.6 and 36.9 +/- 1.2 vs. 52.8 +/- 1.9 (mean +/- SEM) for PBMC-2 and DBMC-2 in patients and controls, respectively; 1.36 +/- 0.03 vs. 1.70 +/- 0.04 and 1.07 +/- 0.03 vs. 1.35 +/- 0.04 for PBMC/BW and DBMC/BW; 34.00 +/- 1.08 vs. 42.02 +/- 1.27 g for LBMC and 0.886 +/- 0.016 vs. 0.976 +/- 0.018 g/cm2 for LBMD. Both the patients with isolated GH deficiency and the patients with multiple pituitary deficiencies were osteopenic when compared to their respective controls (P < 0.01 to P < 0.0001 for the patients with multiple deficiencies; statistical significance reached for PBMC-2, DBMC-2, and DBMC/BW only, P < 0.05, in the small group of patients with isolated GH deficiency). For the patients (n = 19) who had at least three serial measurements over a period of 6 to 28 months, no decrease in BMC was detected. Our findings indicate that men with GH deficiency of childhood onset present with a low adult bone mass, despite prior GH substitution in most of these subjects. The observations of a more pronounced bone mineral deficit at the forearm (20-30% lower mean values, depending on the type of measurements) than at the lumbar spine (9-19%) and the findings of osteopenia in both the patients with isolated GH deficiency and multiple pituitary deficiencies, support the view that GH deficiency per se is responsible for part of the observed deficit. Longitudinal follow-up suggests that this deficit results more likely from deficient build-up of the bone mass than from premature bone loss.
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页码:118 / 123
页数:6
相关论文
共 17 条
[1]  
ADLARD P, 1989, Hormone Research (Basel), V31, P35
[2]  
AYNSLEYGREEN A, 1976, J PEDIATR-US, V89, P992
[3]   SPINAL AND PERIPHERAL BONE-MINERAL DENSITIES IN ACROMEGALY - THE EFFECTS OF EXCESS GROWTH-HORMONE AND HYPOGONADISM [J].
DIAMOND, T ;
NERY, L ;
POSEN, S .
ANNALS OF INTERNAL MEDICINE, 1989, 111 (07) :567-573
[4]  
FERRANDEZ A, 1970, HELV PAEDIATR ACTA, V6, P566
[5]   INSULIN-LIKE GROWTH FACTOR-I HAS INDEPENDENT EFFECTS ON BONE-MATRIX FORMATION AND CELL REPLICATION [J].
HOCK, JM ;
CENTRELLA, M ;
CANALIS, E .
ENDOCRINOLOGY, 1988, 122 (01) :254-260
[6]   SERUM BONE GLA-PROTEIN AS A MARKER OF BONE-GROWTH IN CHILDREN AND ADOLESCENTS - CORRELATION WITH AGE, HEIGHT, SERUM INSULIN-LIKE GROWTH FACTOR-I, AND SERUM TESTOSTERONE [J].
JOHANSEN, JS ;
GIWERCMAN, A ;
HARTWELL, D ;
NIELSEN, CT ;
PRICE, PA ;
CHRISTIANSEN, C ;
SKAKKEBAEK, NE .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1988, 67 (02) :273-278
[7]   TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS - IS THE ANABOLIC-STEROID NANDROLONE DECANOATE A CANDIDATE [J].
JOHANSEN, JS ;
HASSAGER, C ;
PODENPHANT, J ;
RIIS, BJ ;
HARTWELL, D ;
THOMSEN, K ;
CHRISTIANSEN, C .
BONE AND MINERAL, 1989, 6 (01) :77-86
[8]   LONGITUDINAL-STUDY OF CALCIUM-METABOLISM IN MALE PUBERTY .1. BONE-MINERAL CONTENT, AND SERUM LEVELS OF ALKALINE-PHOSPHATASE, PHOSPHATE AND CALCIUM [J].
KRABBE, S ;
CHRISTIANSEN, C .
ACTA PAEDIATRICA SCANDINAVICA, 1984, 73 (06) :745-749
[9]   AUGMENTATION OF GROWTH-HORMONE SECRETION DURING PUBERTY - EVIDENCE FOR A PULSE AMPLITUDE-MODULATED PHENOMENON [J].
MAURAS, N ;
BLIZZARD, RM ;
LINK, K ;
JOHNSON, ML ;
ROGOL, AD ;
VELDHUIS, JD .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1987, 64 (03) :596-601
[10]  
NILAS L, 1985, J NUCL MED, V26, P1257