Gender variation in PTH sensitivity and rhythmicity following growth hormone replacement in adult growth hormone deficient patients

Ahmad, Aftab; Syed, Mohamed Ahmed; Clewes, A.; Peter, Rajesh; Vora, Jiten; Fraser, WD

doi:10.1111/j.1365-2265.2004.02058.x

Cited by 4 publications

(7 citation statements)

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“…10 GH replacement in AGHD is associated with an increase in target-organ PTH sensitivity, with resultant increased serum calcium and NcAMP and simultaneous reduction in PTH concentration. 12,16,17 The increase in 24-h mean calcium observed after one month of GH replacement in our study is in keeping with previous findings. 12,16,17…”

Section: Discussionsupporting

confidence: 93%

“…12,16,17 The increase in 24-h mean calcium observed after one month of GH replacement in our study is in keeping with previous findings. 12,16,17 GH replacement in AGHD is also associated with changes in the PTH circadian rhythm. 10 In particular, a greater increase in the nocturnal PTH peak and a less sustained afternoon rise in PTH have been reported following GH replacement.…”

Section: Discussionsupporting

confidence: 93%

“…10 The study size was determined by a power calculation that was based on previous studies performed at our centre. 11,12,15–17 Using the nomogram presented by Altman, 18 the power derived with a minimum of four patients, at a significance concentration of 0.05, was greater than 95%.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of serum-adjusted calcium with ionized calcium over a 24-h period in patients with adult growth hormone deficiency before and after growth hormone replacement

et al. 2010

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Background: Difficulties associated with measuring ionized calcium in clinical practice have led to the use of total calcium, with or without adjustment for albumin concentration, as an estimate of calcium metabolism. We examined the correlation between ionized and total/adjusted calcium over a 24-h period in patients with adult growth hormone deficiency (AGHD), a group of patients with previously reported alterations in calcium metabolism. Methods: Four patients with AGHD were consented to the study. They were hospitalized for 24 h where half-hourly blood samples were collected for ionized calcium, total calcium, albumin and creatinine, before and one month after the commencement of growth hormone replacement. Total calcium concentration was adjusted for serum albumin. Results: Strong correlations were found between ionized calcium and adjusted calcium (r 2 ¼ 0.840 and 0.766 for visits 1 and

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

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Correlation of serum-adjusted calcium with ionized calcium over a 24-h period in patients with adult growth hormone deficiency before and after growth hormone replacement

et al. 2010

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“…Such synchronization is called "coupling phenomenon". Coupling phenomenon has been discussed in studies of adult GH deficiency [17,18], and it is defined as bone remodeling initiated by osteoclastic resorption followed by osteoblastic bone formation. Our results showed that the change in bone resorption occurred earlier than that in bone formation regardless of the increase or decrease in GH levels.…”

Section: Disclosurementioning

confidence: 99%

Rapid decline in bone turnover markers but not bone mineral density in acromegalic patients after transsphenoidal surgery

et al. 2014

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Growth hormone (GH) has growth and metabolic functions. It stimulates the production of insulinlike growth factor-I (IGF-I) in the liver. IGF-I mediates the growth promoting activities of GH. Knockout mouse models with disruption of GH receptor, IGF-I or IGF-I receptor, highlight the importance of GH and IGF-I in maintaining bone metabolism and bone mineral density (BMD) [1][2][3]. In human, lack of GH is associated with reduced BMD and osteoporosis is observed in patients with severe adult GH deficiency [4,5]. Furthermore, replacement therapy using recombinant human GH (rhGH) increases BMD in such patients [6,7]. These results indicate that GH and IGF-I play an important role in maintaining bone metabolism and BMD in adulthood, in addition to stimulating longitudinal bone growth in childhood. However, informationRapid decline in bone turnover markers but not bone mineral density in acromegalic patients after transsphenoidal surgery Abstract. Growth hormone (GH) and insulin-like growth factor-I (IGF-I) play important roles in maintaining bone metabolism and bone mineral density (BMD) in adulthood, in addition to stimulating longitudinal bone growth in childhood. However, information on the effect of GH excess on bone metabolism and BMD is incomplete and requires further analysis. The aim of this study is to clarify the effect of rapid decline in GH levels after transsphenoidal surgery (TSS) on bone metabolism in acromegalic patients. In this prospective study, 22 patients (11 males and 11 females) with active acromegaly underwent TSS. Bone formation marker (serum bone alkaline phosphatase: BAP), bone resorption marker (urinary type I collagen cross-linked N-telopeptide: urinary NTx) and BMD were measured before and at 3 and 12 months after TSS. BAP was significantly decreased at 12 months after TSS, but not at 3 months. Urinary NTx was significantly decreased at 3 and 12 months after TSS. BMD did not change after TSS. In conclusion, the rapid fall in GH level after TSS had no effect on BMD for up to 12 months after TSS despite the decrease in markers of bone formation and resorption.

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“…While GH replacement increases PTH target organ sensitivity, this effect is reduced and delayed in women, leading to a delayed increase in bone turnover markers following GH therapy. 46 …”

Section: Gh = Growth Hormone Ghr = Gh Receptor Igf = Insulin-like Gmentioning

confidence: 99%

Bone Metabolism During Chronic Growth Hormone Deficiency – Experimental and Clinical Studies

Ueland¹

2006

European Endocrinology

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Adult-onset growth hormone deficiency (AO-GHD) is most often caused by pituitary or hypothalamic tumours or their treatment, and may serve as a model where the effect of chronic GH deficiency on skeletal metabolism can be studied. While the low bone mass in adults with childhoodonset GHD (CO-GHD) may be explained by deficient bone accretion during childhood, decreased bone mass in AO-GHD may be caused by imbalanced bone remodelling. These patients have secondary osteoporosis characterised by reduced bone mass, decreased bone turnover measured by biochemical markers and increased fracture risk. However, studies on the impact of GH substitution have yielded conflicting results, probably due to high doses and short treatment periods. Longer studies, with treatment periods of one year or more, have shown significant increases in bone mass and turnover.

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Gender variation in PTH sensitivity and rhythmicity following growth hormone replacement in adult growth hormone deficient patients

Cited by 4 publications

References 1 publication

Correlation of serum-adjusted calcium with ionized calcium over a 24-h period in patients with adult growth hormone deficiency before and after growth hormone replacement

Correlation of serum-adjusted calcium with ionized calcium over a 24-h period in patients with adult growth hormone deficiency before and after growth hormone replacement

Rapid decline in bone turnover markers but not bone mineral density in acromegalic patients after transsphenoidal surgery

Bone Metabolism During Chronic Growth Hormone Deficiency – Experimental and Clinical Studies

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