title: Growth hormone therapy improves bone mineral density in children with cerebral palsy: a preliminary pilot study.
abstract: BACKGROUND
  Cerebral palsy is associated with osteopenia, increased fracture risk, short stature, and decreased muscle mass, whereas GH therapy is associated with increased bone mineral density (BMD) and linear growth and improvement in body composition.
  
  
  OBJECTIVE
  We conducted a pilot study to evaluate the effect of 18 months of GH therapy on spinal BMD, linear growth, biochemical markers, and functional measures in children with cerebral palsy.
  
  
  METHODS
  The study was a randomized control trial, conducted from 2002-2005 at the University of California, Los Angeles, Orthopedic Hospital's Center for Cerebral Palsy.
  
  
  METHODS
  Patients included 12 males with cerebral palsy, ages 4.5-15.4 yr.
  
  
  METHODS
  We compared 18 months of GH (50 microg daily) vs. no treatment.
  
  
  METHODS
  Spinal BMD (dual-energy x-ray absorptiometry scan), height, growth factors, and bone markers were assessed.
  
  
  RESULTS
  Ten subjects (five in each group) completed the study. Pre- and post-average height z-scores were -1.47 +/- 0.23 and 0.8 +/- 0.2 (GH-treated group) vs. -1.35 +/- 1.26 and -1.36 +/- 1.27 (control group) (Delta SD score, 0.67 vs. -0.01; P = 0.01). Average change in spinal BMD z-score (Delta SD score corrected for height) was 1.169 +/- 0.614 vs. 0.24 +/- 0.25 in the treated and control groups, respectively (P = 0.03). Osteocalcin, IGF-I, and IGF-binding protein 3 levels increased during GH therapy. There was no change in quality of life scores as measured by the Pediatric Orthopedic Disability Inventory.
  
  
  CONCLUSIONS
  This small pilot study suggests that 18 months of GH therapy is associated with statistically significant improvement in spinal BMD and linear growth.
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, California 90095, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Ali
authors.forename: Melanie
authors.initials: M
authors.lastname: Shim
authors.forename: Eileen
authors.initials: E
authors.lastname: Fowler
authors.forename: Marcia
authors.initials: M
authors.lastname: Greenberg
authors.forename: Donna
authors.initials: D
authors.lastname: Perkins
authors.forename: William
authors.initials: W
authors.lastname: Oppenheim
authors.forename: Pinchas
authors.initials: P
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D010865:Pilot Projects
chemical_list: D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins; D013006:Growth Hormone