Changes in bone mineral density, body composition, and lipid metabolism during growth hormone (GH) treatment in children with GH deficiency

被引:184
作者
Boot, AM
Engels, MAMJ
Boerma, GJM
Krenning, EP
KeizerSchrama, SMPFD
机构
[1] SOPHIA CHILDRENS UNIV HOSP, DIV CLIN CHEM, NL-3015 GJ ROTTERDAM, NETHERLANDS
[2] ERASMUS UNIV ROTTERDAM, HOSP DIJKZIGT, DEPT NUCL MED, NL-3015 GJ ROTTERDAM, NETHERLANDS
关键词
D O I
10.1210/jc.82.8.2423
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Adults with childhood onset GH deficiency (GHD) have reduced bone mass, increased fat mass, and disorders of lipid metabolism. The aim of the present study was to evaluate bone mineral density (BMD), bone metabolism, body composition, and lipid metabolism in GHD children before and during 2-3 yr of GH treatment (GHRx). Forty children with GHD, mean age 7.9 yr, participated in the study of bone metabolism and body composition; and an additional group of 17 GHD children, in the study of lipid metabolism. Lumbar spine BMD, total body BMD, and body composition were measured with dual-energy x-ray absorptiometry. Volumetric BRID (bone mineral apparent density, BMAD) was calculated to correct for bone size. BMD, BMAD, lean tissue mass, bone mineral content, fat mass, and percentage body fat were expressed as so scores (SDS), in comparison with normative data of the same population. Lumbar spine BMD and BMAD and total body BMD were all decreased at baseline. All BMD variables increased significantly during GHRx, lumbar spine BMD SDS, already after 6 months of treatment. Lean tissue mass SDS increased continuously. Bone mineral content SDS started to increase after 6 months GHRx. Fat mass SDS decreased during the first 6 months of GHRx and remained stable thereafter. Biochemical parameters of bone formation and bone resorption did not differ from normal at baseline and increased during the first 6 months of GHRx. Serum 1,25 dihydroxyvitamin D increased continuously during GHRx, whereas PTH and serum calcium remained stable. Lipid profile was normal at baseline. Atherogenic index had decreased and apolipoprotein A1 (Apo-A1) had increased after 3 yr of treatment. In conclusion, children with GHD have decreased bone mass. BMD, together with height and lean tissue mass, increased during GHRx. GHRx had a beneficial effect on lipid metabolism.
引用
收藏
页码:2423 / 2428
页数:6
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