The influence of gender on the short and long‐term effects of growth hormone replacement on bone metabolism and bone mineral density in hypopituitary adults: a 5‐year study

Drake, WM; Rodriguez-Arnao, J.; Weaver, Jolanta U.; James, Ian; Coyte, D.; Spector, Tim D.; Besser, G. M.; Monson, John P.

doi:10.1046/j.1365-2265.2001.01246.x

Cited by 74 publications

(55 citation statements)

References 49 publications

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“…In men and women with GHD, dose titration according to serum IGF-I levels gave women a slightly higher total dose of GH, but men and women experienced the same reduction in central adiposity in response to treatment (17), suggesting that women are less responsive to the same total dose of GH (3,5,46). In this study, dose titration resulted in similar total daily doses of GH and produced similar increments in IGF-I in men and women.…”

Section: Discussionsupporting

confidence: 50%

Body composition during GH replacement in adults – methodological variations with respect to gender

Korányi

Bosæus²,

Alpsten³

et al. 2006

eur j endocrinol

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Objective: Men with growth hormone deficiency (GHD) may be more sensitive to GH treatment than women in terms of changes in body composition. We have studied whether age, body-mass index (BMI) and the different types of methodology used to assess body composition may explain these differences. Design: Forty-four men and forty-four women with GHD, closely matched for age and BMI, were studied before and after 6 months of GH replacement. The dose of GH was individually adjusted. Body composition was assessed by measurements of potassium-40, total body nitrogen (TBN), tritiated water dilution, dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Four-and five-compartment models for body composition were also calculated. Results: The total daily dose of GH was similar in men and women at 6 months. Serum insulin-like growth factor-I (IGF-I) was higher in men than women at baseline and after 6 months of treatment (P ¼ 0.01, paired t-test). The increment was, however, similar. In women, GH treatment reduced body weight and increased TBN. In both men and women, total body water and body cell mass increased, while total body fat (BF) mass decreased. At baseline, mean total BF varied considerably depending on the methodology used, with the highest value obtained from DXA. The changes in BF were, however, less dependent on the methodology, but DXA and BIA demonstrated the largest inconsistency between men and women. Conclusions: These results suggest that gender differences in body composition in response to GH treatment are small, if adjustments are made for baseline factors such as age, BMI and dose of GH. Different methods of body composition measurements produce different results, but changes in response to GH administration are less inconsistent.European Journal of Endocrinology 154 545-553

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Section: Discussionsupporting

confidence: 50%

Body composition during GH replacement in adults – methodological variations with respect to gender

Korányi

Bosæus²,

Alpsten³

et al. 2006

eur j endocrinol

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“…Gender may play a role in determining the response of BMD to GH replacement in adult-onset GHD. In a study of 13 patients receiving GH replacement, monitored over a median of 58 months (range 44-72), Drake et al found a significant improvement in BMD in men whereas women demonstrated stabilisation only (60). This was despite an earlier increase in serum bone-specific alkaline phosphatase (a marker of bone formation) in women than the men (60).…”

Section: Bonementioning

confidence: 84%

“…In a study of 13 patients receiving GH replacement, monitored over a median of 58 months (range 44-72), Drake et al found a significant improvement in BMD in men whereas women demonstrated stabilisation only (60). This was despite an earlier increase in serum bone-specific alkaline phosphatase (a marker of bone formation) in women than the men (60). External pituitary radiotherapy may impact on bone health, as noted in a KIMS database analysis in which pituitary irradiation was associated with reduced BMC prior to GH replacement (mean BMC 2.4 vs 2.8 kg, P!0.01) despite no difference in IGF1 SDS.…”

Section: Bonementioning

confidence: 99%

Adult GH deficiency throughout lifetime

Thomas

Monson

2009

European Journal of Endocrinology

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It is now accepted that adults with severe GH deficiency (GHD) demonstrate impaired physical and psychological well-being and may benefit from replacement with recombinant human GH. Postmarketing surveillance surveys, such as the Pfizer International Metabolic Database (KIMS), were initially set-up to provide safety data on long-term treatment but have the added benefit of providing ongoing observational data on the effect of GH replacement on body composition, lipid and glucose status, hypertension, bone density and quality of life. These data demonstrate that although GHD has clinical impact at all ages, the individual consequences of this condition may take on greater significance at different stages in life. At all ages, accurate, safe diagnosis and appropriate GH dosing are necessary to provide the individual with the best possible outcome.

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“…Markers of bone turnover are increased more rapidly in females than in males, resulting in a short-term reduction in BMD for the first 6 months following the initiation of GH therapy in both genders (Drake et al 2001b). However, BMD in men is significantly improved after prolonged therapy, whereas BMD values in women with similar baseline values remain stable (Johansson et al 1999, Drake et al 2001b). Conversely, an earlier study by Johansson et al (1996) observed lower baseline BMD values in women than in men and a correspondingly larger improvement following GH replacement in women.…”

Section: Body Compositionmentioning

confidence: 99%

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

Hull

Harvey²

2003

Journal of Endocrinology

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The actions of growth hormone (GH) are not restricted to growth: GH modulates metabolic pathways as well as neural, reproductive, immune, cardiovascular, and pulmonary physiology. The importance of GH in most physiological systems suggests that GH deficiency at any age would be associated with significant morbidity. However, prior to the advent of recombinant GH, cadaverderived GH was only used therapeutically to correct the height deficit, and thereby hypothetically improve quality of life (QoL), in GH-deficient children. Physicians now have access to unlimited, albeit expensive, supplies of recombinant GH, and are considering the advisability of GH replacement or supplementation in other patient populations. This paper analyses studies investigating the relationship between GH and QoL in GH-deficient children or adults, in GH-replete short children suffering from idiopathic short stature, Turner syndrome, or intrauterine growth retardation and in GH-deficient or replete elderly adults. Possible mechanisms by which GH might improve QoL at neural and somatic sites are also proposed.

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The influence of gender on the short and long‐term effects of growth hormone replacement on bone metabolism and bone mineral density in hypopituitary adults: a 5‐year study

Cited by 74 publications

References 49 publications

Body composition during GH replacement in adults – methodological variations with respect to gender

Body composition during GH replacement in adults – methodological variations with respect to gender

Adult GH deficiency throughout lifetime

Growth hormone therapy and Quality of Life: possibilities, pitfalls and mechanisms

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