Human growth hormone HGH replacement is important for the restoration of parathyroid hormone sensitivity and improvement in bone metabolism in older adult human growth hormone-deficient patients.
White HD - J Clin Endocrinol Metab - 01-JUN-2005; 90(6): 3371-80
From NIH/NLM MEDLINE
NLM Citation ID:
15741264 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article
Language:
English
Author Affiliation:
Department of Diabetes and Endocrinology, Link 7C, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, United Kingdom. h.white@ukf.net
Authors:
White HD; Ahmad AM; Durham BH; Patwala A; Whittingham P; Fraser WD; Vora JP
Abstract:
Alterations in PTH circadian rhythm and PTH target-organ sensitivity exist in adult HGH-deficient (AGHD) patients and may underlie the pathogenesis of AGHD-related osteoporosis. HGH replacement (HGHR) results in increased bone mineral density, but its benefit in AGHD patients over 60 yr old has been debated. To examine the effect of age on changes in PTH circadian rhythm and target-organ sensitivity after HGHR, we recruited 22 AGHD patients (12 were <60 yr of age, and 10 were >60 yr of age). Half-hourly blood samples were collected for PTH, calcium, phosphate, nephrogenous cAMP (marker of renal PTH activity), type-I collagenbeta C-telopeptide (bone resorption marker), and procollagen type-I amino-terminal propeptide (bone formation marker) before and after 1, 3, 6, and 12 months of treatment with HGHR. Significant PTH circadian rhythms were present in both age groups throughout the study. After HGHR, PTH decreased and nephrogenous cAMP, adjusted calcium, and bone turnover markers increased in both groups, suggesting increased PTH target-organ sensitivity. In younger patients, the changes were significant after 1 month of HGHR, but, in older patients, the changes were delayed until 3 months, with maximal changes at 12 months. Older AHGHD patients derive benefit from HGHR in terms of improvement in PTH sensitivity and bone metabolism. Their response appears delayed and may explain why previous studies have not shown a positive effect of HGHR on bone mineral density in older AHGHD patients.
Major Subjects:
- Bone and Bones / * metabolism
- Human Growth Hormone / * deficiency / * therapeutic use
- Parathyroid Hormone / * blood
Additional Subjects:
- Adenoma / blood
- Aged
- Circadian Rhythm
- Female
- Hormone Replacement Therapy
- Humans
- Male
- Middle Aged
- Phosphates / blood / urine
- Pituitary Neoplasms / blood
- Prolactinoma / blood
- Research Support, Non-U.S. Gov't
Chemical Compound Name:
(Parathyroid Hormone); (Phosphates); 12629-01-5(Human Growth Hormone)