EFFECT OF GROWTH-HORMONE REPLACEMENT ON BONE MASS IN ADULTS WITH ADULT-ONSET GROWTH-HORMONE DEFICIENCY

被引:84
作者
HOLMES, SJ
WHITEHOUSE, RW
SWINDELL, R
ECONOMOU, G
ADAMS, JE
SHALET, SM
机构
[1] CHRISTIE HOSP NHS TRUST,DEPT ENDOCRINOL,MANCHESTER M20 4BX,LANCS,ENGLAND
[2] CHRISTIE HOSP NHS TRUST,DEPT MED STAT,MANCHESTER M20 4BX,LANCS,ENGLAND
[3] UNIV MANCHESTER,DEPT DIAGNOST RADIOL,MANCHESTER M13 9PT,LANCS,ENGLAND
关键词
D O I
10.1111/j.1365-2265.1995.tb02690.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE Previous studies of the effect of GH replacement on bone mass In adults with GH deficiency have produced conflicting results. We have studied the effect of 6 and 12 months of GH replacement on bone mass in adults with adult onset GH deficiency. DESIGN Double blind placebo controlled study of GH replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) for 6 months and an open study for a further 6 or 12 months. PATIENTS Twenty-two adults (10 men, 12 women), aged 41.5 +/- 2.1 years (mean +/- SE, range 23.6-59.5), with adult onset GH deficiency. MEASUREMENTS Single-energy quantitative computed tomography was used to measure vertebral trabecular bone mineral density (BMD), single-photon absorptiometry (SPA) was used to measure forearm cortical and integral bane mineral content and BMD and dual-energy X-ray absorptiometry (DXA) was used to measure lumbar spine, femoral neck, trochanteric and Ward's triangle integral BMD. RESULTS After 6 months of GH replacement (n = 21) there was a significant decrease in forearm cortical BMD (SPA: median change -0.009 g/cm(2), P=0.01), forearm integral BMD (SPA: median change -0.016 g/cm(2), P=0.03), lumbar spine BMD (DXA: median change -0.022 g/cm(2); P=0.003) and femoral neck BMD (DXA: median change -0.029 g/cm(2), P=0.006). After 12 months of GH replacement (n = 13) there was a significant decrease in lumbar spine BMD (DXA: median change -.0035 g/cm(2), P=0.002) from baseline. There was no significant increase in bone mass at any site after 6 or 12 months of GH replacement. Change in bone mass was not influenced by sex of the patient or by presence or absence of additional pituitary hormone deficiencies. CONCLUSION The response of bone mass to 6 and 12 months of GH replacement in adults with adult onset GH deficiency is disappointing. Longer-term studies are required to determine whether prolonged GH replacement has a beneficial effect on bone mass.
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页码:627 / 633
页数:7
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共 28 条
  • [11] Degerblad M., Elgindy N., Hall K., Sjoberg H.-E., Thoren M., Potent effect of recombinant growth hormone on bone mineral density and body composition in adults with panhypopituitarism, Acta Endocrinologica, 126, pp. 387-393, (1992)
  • [12] Holmes S.J., Economou G., Whitehouse R.W., Adams J.E., Shalet S.M., Reduced bone mineral density in patients with adult onset growth hormone deficiency, Journal of Clinical Endocrinology and Metabolism, 78, pp. 669-674, (1994)
  • [13] Hyer S.L., Rodin D.A., Tobias J.H., Leiper A., Nussey S.S., Growth hormone deficiency during puberty reduces adult bone mineral density, Archives of Disease in Childhood, 67, pp. 1472-1474, (1992)
  • [14] Johansson A.G., Burman P., Westermark K., Ljunghall S., The bone mineral density in acquired growth hormone deficiency correlates with circulating levels of insulin‐like growth factor I, Journal of Internal Medicine, 232, pp. 447-452, (1992)
  • [15] Johannsson G., Rosen T., Bosaeus I., Hallgren P., Bengtsson B.-A., The effects of 2 years treatment with recombinant human growth hormone (RHGH) in growth hormone deficient adults (GHDA), Endocrinology and Metabolism, 1, Suppl. B, (1994)
  • [16] Johansen J.S., Pedersen S.A., Jorgensen J.O.L., Riis B.J., Christiansen C., Christiansen J.S., Skakkebaek N.E., Effects of growth hormone (GH) on plasma bone gla protein in GH‐deficient adults, Journal of Clinical Endocrinology and Metabolism, 70, pp. 916-919, (1990)
  • [17] Kaufman J.-M., Taelman P., Vermeulen A., Vandeweghe M., Bone mineral status in growth hormone‐deficient males with isolated and multiple pituitary deficiencies of childhood onset, Journal of Clinical Endocrinology and Metabolism, 74, pp. 118-123, (1992)
  • [18] O'Halloran D.J., Tsatsoulis A., Whitehouse R.W., Holmes S.J., Adams J.E., Shalet S.M., Increased bone density after recombinant human growth hormone (GH) therapy in adults with isolated GH deficiency, Journal of Clinical Endocrinology and Metabolism, 76, pp. 1344-1348, (1993)
  • [19] Rosen T., Hansson T., Granhed H., Szucs J., Bengtsson B.-A., Reduced bone mineral content in adult patients with growth hormone deficiency, Acta Endocrinologica, 129, pp. 201-206, (1993)
  • [20] Rosen T., Johannsson G., Hallgren P., Caidahl K., Bosaeus I., Bengtsson B.-A., Beneficial effects of 12 months replacement therapy with recombinant human growth hormone to growth hormone deficient adults, Endocrinology and Metabolism, 1, pp. 55-66, (1994)