PMID: 20629339Jul 16, 2010Paper

Growth hormone deficiency, its influence on bone mineral density and risk of osteoporotic fractures

Casopís lékar̆ů c̆eských
M Kužma, J Payer

Abstract

Growth hormone (GH) is the most abundant hormone from all pituitary hormones. Linear bone growth increases as a result of complex hormonal reactions, in particular as an effect of insulin-like growth factor I (IGF I). GH has a key role in longitudinal bone growth and in reaching peak bone mass (PBM) during childhood and adolescence. PBM is a important risk predictor of osteoporotic fractures. Despite closure of epiphyseal growth plates, effect of GH/IGF on bone turnover, bone mass, bone density and strength lasts by regulation of bone remodelation. Many authors have observed low BMD in hypopituitarismus, especially in growth hormone deficient (GHD) patients. Initially reduction of BMD has been described after 6-12 months of therapy with growth hormone. When therapy continued, BMD has normalized or was even higher in comparison with the beginning of the therapy. Reduction in BMD results from increased remodelation space after enhanced activation of bone turnover during GH therapy. Decrease in bone growth and PBM also influences incidence of fractures in elderly patients. It has been shown, that 18-24 months of GH therapy slightly increased BMD in a group of adult men with adult onset of GHD (AO-GHD), whereas in women it has not ...Continue Reading

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