Scoliosis in Patients Treated with Growth Hormone

Wang, Edward D.; Drummond, Denis S.; Dormans, John P.; Moshang, Thomas; Davidson, Richard S.; Gruccio, Denise

doi:10.1097/01241398-199711000-00003

Cited by 37 publications

(41 citation statements)

References 19 publications

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“…As rapid growth was evident during an early period of GH therapy [Myers et al, 2000;Obata et al, 2003], this would lead to an increased risk of the development or accelerated progression of scoliosis in younger PWS patients with GH therapy [Dymling and Willner, 1978;Wang et al, 1997;Nishi et al, 1998]. However, our data showed that the frequency of scoliosis was not statistically different at any ages between patients who received GH and those without it (Table I).…”

Section: Discussioncontrasting

confidence: 52%

Growth hormone therapy and scoliosis in patients with Prader–Willi syndrome

Nagai

Obata

Ogata

et al. 2006

American J of Med Genetics Pt A

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Growth hormone (GH) therapy for short stature in patients with Prader-Willi syndrome (PWS) has started worldwide, and various favorable effects have been reported. However, the possibility of progression of scoliosis arises as a new problem of the GH therapy. In this study, we analyzed whether 72 patients who have been followed up in our hospital have such a problem. They included 46 males and 26 females (41 patients with the GH therapy and 31 without it) aged from one to 49 years. Consequently, 33 (45.8%) of 72 patients had scoliosis with the Cobb angle of >10 degrees. Twenty (48.8%) of forty-one patients who received a GH therapy and 13 (41.9%) of 31 patients without the therapy had scoliosis, the frequency of scoliosis between the two groups showing no statistical difference (P = 0.56). Height velocity of scoliotic and non-scoliotic patients during the first year of the therapy was 8.59 +/- 1.92 and 10.70 +/- 2.54 cm, respectively, showing a significant difference (P < 0.001). This shows that accelerated height velocity may not induce scoliosis. Comparison of starting age of a GH treatment revealed that non-scoliotic patients received the therapy earlier than scoliotic patients (P = 0.021). Among 20 scoliotic patients who received the GH therapy, the degree of scoliosis progressed during the therapy in six patients, improved in three and fluctuated in one. Many patients showed progression of scoliosis with age irrespective of the use of GH, and some patients improved their scoliosis during the GH therapy. These findings showed that a GH therapy increases height velocity of PWS patients but does not necessarily develop scoliosis, and early start of the therapy may not be an exacerbating factor of scoliosis.

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Section: Discussioncontrasting

confidence: 52%

Growth hormone therapy and scoliosis in patients with Prader–Willi syndrome

Nagai

Obata

Ogata

et al. 2006

American J of Med Genetics Pt A

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“…The cause of scoliosis is believed to be multifactorial due to the associations between the development of scoliosis and growth, hormonal secretion, gravity and others [1,15,16,21,26,27,33,36,43]. However, none of these parameters has been demonstrated to play a causative role in the development of AIS.…”

Section: Introductionmentioning

confidence: 99%

Polymorphism in vitamin D receptor is associated with bone mineral density in patients with adolescent idiopathic scoliosis

2010

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Low bone mass and osteopenia have been reported in the axial and peripheral skeleton of adolescent idiopathic scoliosis (AIS) patients. Furthermore, several recent studies have shown that gene polymorphisms are related to osteoporosis. However, no study has yet linked polymorphisms in the vitamin D receptor (VDR) gene and bone mass in AIS. Accordingly, the authors examined the association between bone mass and VDR gene polymorphisms in 198 girls diagnosed with AIS. The VDR BsmI (rs1544410), FokI (rs2228670) and Cdx2 (rs11568820) polymorphisms and bone mineral density at the lumbar spine (LSBMD) and femoral neck (FNBMD) were analyzed and compared to their levels in healthy controls. Mean LSBMD and FNBMD in AIS patients were lower than in age-and sex-matched healthy controls (P = 0.0022 and P = 0.0013, respectively). A comparison of genotype frequencies in AIS patients and controls revealed a significant difference for the BsmI polymorphism only (P = 0.0054). Furthermore, a significant association was found between the VDR BsmI polymorphism and LSBMD. In particular, LSBMD in AIS patients with the AA genotype was found to be significantly lower than in patients with the GA (P \ 0.05) or GG (P \ 0.01) genotypes. However, no significant association was found between LSBMD or FNBMD and the VDR FokI or Cdx2 polymorphisms. These results suggest that the VDR BsmI polymorphism is associated with LSBMD in girls with AIS.

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“…In a study of 250 children treated with GH, 10 of 250 patients (4%) were found to have scoliosis while receiving therapy, with six of 10 requiring medical bracing or spinal fusion. 23 Of these 10 patients, four had prior treatment with central nervous system and/or spinal radiation. The rapid progression of scoliosis in their patients on GH treatment led the authors to conclude that GH treatment may increase the risk of progression of scoliosis in patients with other independent risk factors.…”

Section: Discussionmentioning

confidence: 99%