Effects of long-term rhGH replacement on bone

Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are important regulators of bone growth and metabolism during a person’s life span. Growth hormone deficiency (GHD) in adulthood may be associated with a decreased bone mineral density (BMD), a decreased bone mineral content (BMC) and an increased fracture risk. Treatment with recombinant human GH (rhGH) replacement induces a progressive increase in BMD for up to 5 – 7 years of treatment. Data on longer follow-up periods are, however, scarce.

Appelman-Dijkstra et al. aimed to assess the effects of 5, 10 and 15 years of rhGH replacement on bone metabolism in the Leiden Cohort Study, a well-characterized cohort of 238 adult GHD patients. They alao  studied potential influencing factors on the bone response to rhGH replacement and studied clinical fracture incidence in these patients.

They found a sustained increase in BMD at the lumbar spine during the first 10 years of rhGH replacement, and stabilization of BMD values at the femoral neck.. At all time points, the largest effects of rhGH replacement on lumbar spine BMD and BMC were observed in men. Clinical fracture incidence appeared not to be increased during long-term rhGH replacement.

Read full article titled at Appelman-Dijkstra et al. (2014) Clinical Endocrinology 81 (5) 727-735; DOI: 10.1111/cen.12493