Cortical bone density is normal in prepubertal children with human growth hormone HGH deficiency, but initially decreases during HGH replacement due to early bone remodeling.
Schweizer R - J Clin Endocrinol Metab - 01-NOV-2003; 88(11): 5266-72
From NIH/NLM MEDLINE
NLM Citation ID:
14602760 (PubMed)
Comment:
- J Clin Endocrinol Metab. 2004 May;89(5):2505; author reply 2505-6
PubMed ID: 15126585
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Clinical Trial; Journal Article
Language:
English
Author Affiliation:
Pediatric Endocrinology Section, University Children's Hospital, University of Tuebingen D-72076, Germany. roland.schizer@med.uni-tuebingen.de
Authors:
Schweizer R; Martin DD; Schwarze CP; Binder G; Georgiadou A; Ihle J; Ranke MB
Abstract:
Dual energy x-ray absorptiometry (DEXA) has revealed that HGH- deficient adults gain in bone mineral density during GH therapy. Measurements of volumetric bone density (grams per cubic centimeter vs. grams per square centimeter) and structure, however, are achieved through peripheral quantitative computed tomography (pQCT). In 45 prepubertal HGH-deficient children, we studied pQCT measurements before the start and for 12 months of HGH treatment. Serum alkaline phosphatase (AP), procollagen I carboxyl-terminal propeptide (PICP), and deoxypyridinoline reflected bone metabolism status. Findings at the start of HGH treatment were (mean SD score): bone area, -0.44; cortical density, -0.03; cortical area, -1.32; cortical thickness, -1.41; and marrow area, +0.66. At 12 months, cortical density had fallen to -0.73 (P < 0.001), whereas cortical area and thickness, and marrow area did not change. AP, PICP, and deoxypyridinoline increased significantly within the first 3 months (increase: AP, 66.5 U/liter; PICP, 72 microg/liter; DPD, 11.4 nmol/mmol creatinine). The pQCT showed that cortical density is not reduced in GH-deficient patients. Higher bone metabolism explains the lower cortical density after HGH therapy commenced. Thus, the manifestation of HGH deficiency is evidently similar in children and adults, and pQCT provides important information in addition to DEXA measurements, as DEXA does not take bone structure into account.
Major Subjects:
- Bone Density / * drug effects
- Bone Remodeling / * drug effects
- Growth Disorders / * drug therapy / metabolism / radiography
- Human Growth Hormone / * administration & dosage / * deficiency
Additional Subjects:
- Adolescent
- Bone and Bones / drug effects / metabolism / radiography
- Child
- Child, Preschool
- Densitometry, X-Ray
- Female
- Humans
- Male
- Prospective Studies
- Research Support, Non-U.S. Gov't
- Tomography, X-Ray Computed / methods
Chemical Compound Name:
12629-01-5(Human Growth Hormone)