Impact of the growth hormone replacement on bone status in growth hormone deficient adults

Kužma, Martin; Kužmová, Zuzana; Zelinková, Zuzana; Killinger, Zdenko; Vaňuga, Peter; Lazúrová, Ivica; Tomková, S; Payer, Juraj

doi:10.1016/j.ghir.2013.12.001

Cited by 39 publications

(26 citation statements)

References 51 publications

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“…TBS was also assessed in other conditions related to increased fracture risk (45,54,56,61,62,64,71). However, these studies either enrolled a small number of individuals and fractured cases or have not investigated the ability of TBS to assess fracture risk.…”

Section: Discussionmentioning

confidence: 99%

“…Over the mean follow-up of 2 yr, there was a mean increase in TBS of 4.3%, which was significantly greater than the 0.3% increase in TBS in women treated with ibandronate. One study looked at patients with GH deficiency (56). Treatment with recombinant human GH resulted in a significant improvement in both TBS and BMD with the same pattern of a greater increase in BMD than TBS: 14% vs 4%.…”

Section: Rationalementioning

confidence: 99%

“…The effect of GH replacement on TBS was examined in 147 patients with GH deficiency (mean age 35.1 yr; 84 males) (56). GH replacement for 2 yr led to significant improvements in BMD at LS (þ14%) and total femur (þ7%; both p 0.001 relative to baseline).…”

Section: Conditions Related To Increased Fracture Riskmentioning

confidence: 99%

See 2 more Smart Citations

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 2: Trabecular Bone Score

Silva

Broy

Boutroy

et al. 2015

Journal of Clinical Densitometry

291

193

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Section: Discussionmentioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

See 1 more Smart Citation

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 2: Trabecular Bone Score

Silva

Broy

Boutroy

et al. 2015

Journal of Clinical Densitometry

291

193

View full text Add to dashboard Cite

“…Using appropriate size corrections, bone density in children with isolated GHD is normal [34]. Indeed, supplementation of GH increases bone turnover and increases trabecular bone score reflecting bone remodeling in favor of improving its quality [35]. However, there is yet no clear evidence of increased fracture risk of patients with childhood-onset isolated GHD [10].…”

Section: Discussionmentioning

confidence: 99%

Natural History of Growth Hormone Deficiency in a Pediatric Cohort

Deillon

Hauschild

Faouzi³

et al. 2015

Horm Res Paediatr

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Background/Aims: Controversies still exist regarding the evaluation of growth hormone deficiency (GHD) in childhood at the end of growth. The aim of this study was to describe the natural history of GHD in a pediatric cohort. Methods: This is a retrospective study of a cohort of pediatric patients with GHD. Cases of acquired GHD were excluded. Univariate logistic regression was used to identify predictors of GHD persisting into adulthood. Results: Among 63 identified patients, 47 (75%) had partial GHD at diagnosis, while 16 (25%) had complete GHD, including 5 with multiple pituitary hormone deficiencies. At final height, 50 patients underwent repeat stimulation testing; 28 (56%) recovered and 22 (44%) remained growth hormone (GH) deficient. Predictors of persisting GHD were: complete GHD at diagnosis (OR 10.1, 95% CI 2.4-42.1), pituitary stalk defect or ectopic pituitary gland on magnetic resonance imaging (OR 6.5, 95% CI 1.1-37.1), greater height gain during GH treatment (OR 1.8, 95% CI 1.0-3.3), and IGF-1 level <-2 standard deviation scores (SDS) following treatment cessation (OR 19.3, 95% CI 3.6-103.1). In the multivariate analysis, only IGF-1 level <-2 SDS (OR 13.3, 95% CI 2.3-77.3) and complete GHD (OR 6.3, 95% CI 1.2-32.8) were associated with the outcome. Conclusion: At final height, 56% of adolescents with GHD had recovered. Complete GHD at diagnosis, low IGF-1 levels following retesting, and pituitary malformation were strong predictors of persistence of GHD.

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“…A recent prospective study evaluated the effect of growth hormone (GH) replacement on TBS in 147 subjects with growth hormone deficiency (GHD; mean age 35.1 years; 84 males) (40). Compared to baseline, there was a significant increase in BMD at LS (+14%) and total femur (+7%) at 2 years of GH replacement (both p ≤ 0.001).…”

Section: Other Conditionsmentioning

confidence: 99%

Trabecular bone score: perspectives of an imaging technology coming of age

Silva

Bilezikian

2014

Arq Bras Endocrinol Metab

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The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross--sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology. Arq Bras Endocrinol Metab. 2014;58(5):493-503 Keywords Trabecular bone score; osteoporosis; fracture risk; bone mineral density; microarchitecture RESUMO TBS (do inglês, "trabecular bone score") é um novo método que estima a microarquitetura óssea a partir de uma imagem de densitometria óssea (DXA) da coluna lombar. Apesar de o TBS não ser uma medida física direta da microarquitetura trabecular, ele correlaciona-se com o volume ósseo, densidade da conectividade trabecular, número de trabéculas e separação trabecular medidos por microtomografia computadorizada (µCT), e com medidas mecânicas da resistência óssea vertebral em estudos ex vivo. Estudos em humanos confirmaram que o TBS associa-se a microarquitetura trabecular e resistência óssea medidas por tomografia computadorizada quantitativa periférica de alta resolução (HRpQCT). Estudos transversais e prospectivos, envolvendo um grande número de indivíduos, mostraram que o TBS é associado com fratura vertebral, de colo de fêmur e com outros tipos de fraturas osteoporóticas em mulheres na pós-menopausa. Dados em homens, apesar de escassos, mostram resultados semelhantes. Além disso, o TBS foi associado a fraturas por fragilidade em indivíduos com diversas causas secundárias de osteoporose e, dados preliminares, sugerem que o uso do TBS pode melhorar a previsão de fratura quando incorporado ao sistema de avaliação de risco de fratura (FRAX). Este artigo faz uma revisão de avanços recentes que têm ajudado a estabelecer esse novo mé-todo de imagem. Arq Bras Endocrinol Metab. 2014;58(5):493-503 Descritores

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Impact of the growth hormone replacement on bone status in growth hormone deficient adults

Cited by 39 publications

References 51 publications

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 2: Trabecular Bone Score

Fracture Risk Prediction by Non-BMD DXA Measures: the 2015 ISCD Official Positions Part 2: Trabecular Bone Score

Natural History of Growth Hormone Deficiency in a Pediatric Cohort

Trabecular bone score: perspectives of an imaging technology coming of age

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