Histomorphometric analysis of bone mass and bone metabolism in growth hormone deficient adult men

Bravenboer, Nathalie; Holzmann, P.; Boer, H. de; Blok, G.J.; Lips, Paul

doi:10.1016/8756-3282(96)00069-5

Cited by 58 publications

(23 citation statements)

References 21 publications

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“…These results are generally consistent with findings reported for adults with childhood onset GH deficiency. (30) Bone formation rates and bone volumes were normal, but trabecular bone volume was increased in a third of those patients. We found that most measurements of bone physiology were not different in controls and adults with GHRD.…”

Section: Discussionmentioning

confidence: 99%

Bone Mineral, Histomorphometry, and Body Composition in Adults with Growth Hormone Receptor Deficiency

Bachrach

Marcus

Ott

et al. 1998

Journal of Bone and Mineral Research

103

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Growth hormone (GH) and insulin-like growth factor I (IGF-I) deficiencies have been associated with osteopenia in both children and adults. To examine the effects of growth hormone resistance on bone mineral and body composition, we studied 11 adults (mean age 30 years) with growth hormone receptor deficiency (GHRD, Laron syndrome) and 11 age-and gender-matched controls from Southern Ecuador. Bone mineral and body composition were determined by dual-energy X-ray absorptiometry. Bone physiology was assessed with biochemical markers of bone turnover and dynamic bone histomorphometry. Bone size and body composition differed markedly between subjects with GHRD and controls. Affected adults were 40 cm shorter than controls, had significantly less lean body mass, and had increased percent body fat. Bone mineral content and density (BMD) at the spine, femoral neck, and whole body were significantly lower in adults with GHRD than in controls. Mean BMD Z scores were ؊1.5 to ؊1.6 at all sites in affected women and ؊2.2 to ؊2.3 in men with GHRD. Estimated volumetric bone density (BMAD) at the spine and femoral neck, however, was not reduced in GHRD. Spine BMAD was 0.210 ؎ 0.025 versus 0.177 ؎ 0.021 for affected women versus controls ( p < 0.05) and 0.173 ؎ 0.018 versus 0.191 ؎ 0.025 for men with GHRD versus normals ( p ‫؍‬ 0.31). Urinary pyridinoline concentrations were significantly greater in adults with GHRD than in controls, while type I collagen C-telopeptide breakdown products and markers of bone formation did not differ. Differences in histomorphometry were limited to a reduction in trabecular connectivity; bone volume and formation rate were similar to controls. These data confirm the importance of the GH/IGF axis in regulating bone size and body composition. The contribution of these peptides to the acquisition and maintenance of bone mineral is less certain since volumetric bone density was preserved despite low levels of IGF-I and IGFBP-3 associated with GH resistance. (J Bone Miner Res 1998;13:415-421)

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Section: Discussionmentioning

confidence: 99%

Bone Mineral, Histomorphometry, and Body Composition in Adults with Growth Hormone Receptor Deficiency

Bachrach

Marcus

Ott

et al. 1998

Journal of Bone and Mineral Research

103

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“…The studies of bone biopsies and fracture incidence in patients with GHD with and without GH replacement are therefore of great importance. Histomorphometric analysis of bone in GHD men showed higher eroded surface of iliac bone and a tendency to lower osteoid surface, mineralizing surface, and bone formation rate [95]. After 5 years of GH replacement therapy, Bravenboer and coworkers were able to demonstrate increased osteoid surface, osteoid volume and activation frequency in GHD men [96].…”

Section: Bone Metabolismmentioning

confidence: 96%

Management of growth hormone deficiency in adults

Nilsson

Svensson

Johannsson

2007

Growth Hormone & IGF Research

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“…This indicates a normalization of BMD for 40-50% of the patients [27], Using BMD-fracture risk relationship data for women, it is estimated that the mean risk of fractures after 2 years of GH treatment would decrease by a factor of 1.5, which is almost the same as the reported increase in fracture rate in GH-deficient adults [64], It should be remembered, however, that the patho physiology behind the low bone mass in osteoporotic women and in GH-deficient adults is not the same. This is demonstrated in a recent histomorphometric analysis of young men with GH deficiency [65]. These individuals had a normal or high trabecular bone volume with an increased eroded surface which suggested a prolonged resorption period and reversal phase, with a tendency to a lower bone formation rate and delayed mineralization.…”

Section: Orbiditymentioning

confidence: 94%

Growth Hormone and the Acquisition of Bone Mass

Johannsson¹,

Bengtsson²

1997

Horm Res

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Bone remodelling is a continuous, closely coupled process of bone resorption followed by bone formation. This process is regulated by factors and hormones which include GH, IGF-I and gonadal steroids. GH deficiency in childhood results in short stature and delayed bone maturation and a reduced peak bone mass might account for reduced BMC and BMD. Possible pathophysiological mechanisms for reduced bone mass in both childhood- and adult-onset GH deficiency are discussed. GH treatment effects on bone metabolism include increased remodelling, with increases in BMC, BMD and bone area. Increases in BMC and BMD are delayed while these changes are incorporated into the skeleton. BMC increases to a greater extent than BMD. At a cellular level, GH and IGF-I have direct and indirect effects on osteoblast and osteoclast precursors and fully differentiated cells. Osteoblasts possess both oestrogen and androgen receptors and bone loss accelerates with the loss of gonadal function. There are gender differences in GH effects on bone. BMD is related to fracture risk in the hip and lumbar spine in women. GH treatment might decrease fracture risk at a level comparable to oestrogen or bisphosphonate treatment. Patients with the lowest BMD prior to treatment derive the greatest benefit from GH therapy.

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Histomorphometric analysis of bone mass and bone metabolism in growth hormone deficient adult men

Cited by 58 publications

References 21 publications

Bone Mineral, Histomorphometry, and Body Composition in Adults with Growth Hormone Receptor Deficiency

Bone Mineral, Histomorphometry, and Body Composition in Adults with Growth Hormone Receptor Deficiency

Management of growth hormone deficiency in adults

Growth Hormone and the Acquisition of Bone Mass

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