Serum collagen crosslinks as markers of bone turn‐over during GH replacement therapy in growth hormone deficient adults

Rodriguez-Arnao, J.; James, Ian; Jabbar, Absia; Trainer, Peter J; Perrett, David; Besser, G. M.; Ross, R. J. M.

doi:10.1046/j.1365-2265.1998.00405.x

Cited by 24 publications

(8 citation statements)

References 42 publications

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“…The same trial reported a significant increase in peak handgrip strength in females while reporting insignificant changes or significant reductions in BMD/BMC (20). In two trials, the significant increases in muscle parameters occurred prior to the significant increases in bone parameters (17,18,37). In one trial, however, the increase in lumbar spine BMD was contemporary with the increase in muscle parameters (17).…”

Section: Effect Of Ghd and Gh Replacement On Both Muscles And Bonesmentioning

confidence: 90%

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Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency? A systematic literature analysis

Klefter¹,

Feldt‐Rasmussen²

2009

European Journal of Endocrinology

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Objective: Adult patients with GH deficiency (GHD) are characterized by a reduced muscle mass, but also reduced bone mineral density (BMD) and content (BMC), which have been ascribed to GHD per se.The aim of this study was to investigate if changes in BMD/BMC in adult GHD patients could be due to a muscle modulating effect, and if treatment with GH would primarily increase muscle mass and strength with a secondary increase in BMD/BMC, thus supporting the present physiological concept that mass and strength of bones are mainly determined by dynamic loads from the skeletal muscles. Method: We performed a systematic literature analysis, including 51 clinical trials published between 1996 and 2008, which had studied the development in muscle mass, muscle strength, BMD, and/or BMC in GH-treated adult GHD patients. Results: GH therapy had an anabolic effect on skeletal muscle. The largest increase in muscle mass occurred during the first 12 months of therapy. Most trials measuring BMD/BMC reported significant increases from baseline values. The significant increases in BMD/BMC occurred after 12-18 months of treatment, i.e. usually later than the increases in muscle parameters. Only seven trials studied both muscle and bone variables concomitantly. No trials studied the relationship between the changes in muscle and bone measurements. Conclusion: Although in vitro studies have shown that GH has a direct effect on bone remodeling, present physiological concepts and the results of clinical trials from 1996 to 2008 suggest that the anabolic changes in muscle mass and strength may also contribute to changes in BMD/BMC in GH-treated adult GHD patients.

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Section: Effect Of Ghd and Gh Replacement On Both Muscles And Bonesmentioning

confidence: 90%

“…Two trials reporting significant increases in muscle strength, also found significant increases in most, but not all, BMD and BMC values (18,21,37).…”

Section: Effect Of Ghd and Gh Replacement On Both Muscles And Bonesmentioning

confidence: 99%

Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency? A systematic literature analysis

Klefter¹,

Feldt‐Rasmussen²

2009

European Journal of Endocrinology

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“…It is difficult to speculate on the possible mechanisms involved in the process in vivo. The use of bone turnover markers is controversial (20)(21)(22). In fact, while in postmenopausal women, there is a correlation between bone turnover markers and BMD (23), in the same patients B-ALP and short-term changes in collagen cross-links during therapy are important predictive factors in bone mass recovery (23).…”

Section: Discussionmentioning

confidence: 99%

The reduction of bone mineral density in postmenopausal women with primary hyperparathyroidism is higher in the presence of concomitant GH secretion impairment

et al. 2006

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Objective: To investigate, in a large group of postmenopausal primary hyperparathyroidism (PHP) women, whether the concomitance of GH deficiency (GHD) may contribute to the development of changes in bone mineral density (BMD). Design: GH secretion, bone status and metabolism were investigated in 50 postmenopausal women with PHP and in a control group of 60 women with no evidence of PHP, matched for age, age at menopause and body mass index (BMI). Methods: GH response to growth hormone-releasing hormone (GHRH)Carginine (Arg), femoral neck BMD (g/cm 2 ) by dual energy X-ray absorptiometry, BMI, serum-ionized calcium, parathyroid hormone (PTH) and markers of bone remodelling were evaluated in all patients and controls. Results: Among PHP patients, GH secretion was reduced (8.8G4.2 mg/l, range 1.1-16.5 mg/l) in 34 patients and normal (28.7G11.8 mg/l, range 17.9-55.7 mg/l) in the remaining 16 (P!0.05), no women in the control group had GHD (peak GH 33.8G10.9 mg/l, range 21.7G63.2 mg/l). Osteoporosis (T-score!K2.5) and osteopenia (T-scoreOK2.5 and !K1) were found in 73.5 and 17.6% of GHD patients, in 37.5 and 43.7% of patients with normal GH secretion and 3.1 and 27% of controls. T-score and BMD were not correlated with ionized calcium, age, age at menopause, BMI, GH peak and IGF-I but were correlated with serum PTH levels in both groups. T-score was correlated with serum levels of markers of bone remodelling only in PHP patients with GHD. Conclusions: Concomitant impairment of GH secretion may play a pathogenetic role in the occurrence of changes in bone mass observed in PHP and contribute to make them more severe. European Journal of Endocrinology 155 41-45

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“…Estudos com uso de GH a longo prazo (pelo menos 18-24 meses) mostram aumento na DMO, mas ainda não se sabe se isso se traduz em uma redução no risco de fraturas (5,(49)(50)(51)(52)(53)(54). Encontramos aumento da DMO de coluna lombar e fêmur após 12 meses de reposição de GH (1,99±4,27% em coluna lombar e 2,55±4,30% no fêmur), que se manteve após 24 meses de tratamento (2,31±7,17% em coluna lombar e 5,33±9,64% no fêmur).…”

Section: Deficiência De Gh Em Adultos: Estudo Brasileirounclassified

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

Conceição

Boguszewski

Meister

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOAvaliamos 70 pacientes com deficiência de GH, 39 mulheres e 31 homens, com idades entre 18 e 69 anos (média de 38,3±13,5), provenientes de 3 centros no Brasil. A dose de reposição variou entre os centros, bem como a resposta do IGF-1, que mostrou maior aumento nos centros com maior dose de GH. Reposição de GH levou a um aumento significativo nos níveis de IGF-1 e HDL colesterol, bem como da densidade mineral óssea (DMO), e a uma redução significativa nos níveis de colesterol total e LDL colesterol, semelhante nos 3 centros. Encontramos aumento mais significativo de HDL colesterol nas mulheres e aumento mais acentuado da DMO nos pacientes do sexo masculino. Concluimos que reposição de GH leva à melhora do perfil lipídico e da DMO, e que doses menores apresentam o mesmo benefício, provavelmente com menor incidência de efeitos colaterais. ABSTRACT GH Deficiency in Adults: Results of the Brazilian Multicenter Study.We have evaluated 70 patients with GH deficiency, 39 females and 31 males, ranging in age from 18 to 69 years (mean: 38.3±13.5), from 3 centers in Brazil. GH replacement dose was different among the centers, as well as IGF-1 response to GH, which was more pronounced in patients using the highest GH dose. GH replacement led to a significant increase of IGF-1 and HDL cholesterol, as well as bone mineral density (BMD) and to a significant decrease in total and LDL cholesterol that was similar among the centers. Female patients showed a more significant increase of HDL cholesterol, while men showed a more significant increase of BMD. In conclusion, GH replacement led to an improvement of lipid profile and BMD. Lower GH dose may lead to the same benefits, probably with a lower incidence of side effects.

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Serum collagen crosslinks as markers of bone turn‐over during GH replacement therapy in growth hormone deficient adults

Cited by 24 publications

References 42 publications

Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency? A systematic literature analysis

Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency? A systematic literature analysis

The reduction of bone mineral density in postmenopausal women with primary hyperparathyroidism is higher in the presence of concomitant GH secretion impairment

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

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