Effect of growth hormone replacement on BMD in adult-onset growth hormone deficiency.
To determine if replacement of GH improves BMD in adult-onset GHD, we administered GH in physiologic amounts to men and women with GHD. GH replacement significantly increased spine BMD in the men by 3.8%.


BACKGROUND
Growth hormone (GH) deficiency (GHD) acquired in adulthood results in diminished BMD; the evidence that replacement of GH improves BMD is not conclusive. We therefore performed a randomized, placebo-controlled trial to determine whether GH replacement would increase lumbar spine BMD in a combined group of men and women with adult-onset GHD.


METHODS
We randomized 67 men and women to receive GH (n=33) or placebo (n=34) for 2 yr. The GH dose was initially 2 microg/kg body weight/d, increased gradually to a maximum of 12 microg/kg/d and adjusted to maintain a normal IGF-I concentration for age and sex. BMD was assessed before treatment and at 6, 12, 18, and 24 mo of treatment. Fifty-four subjects completed the protocol.


RESULTS
BMD of the lumbar spine in the entire group increased by 2.9 +/- 3.9% above baseline in the GH-treated subjects, which was significantly (p=0.037) greater than the 1.4 +/- 4.5% increase in the placebo-treated subjects. In a secondary analysis, spine BMD in GH-treated men increased 3.8 +/- 4.3% above baseline, which was significantly (p=0.001) greater than that in placebo-treated men (0.4 +/- 4.7%), but the change in GH-treated women was not significantly different from that in placebo-treated women. Treatment with GH did not increase total hip BMD more than placebo treatment after 2 yr.


CONCLUSIONS
We conclude that GH replacement in men who have adult-onset GHD improves their spine BMD, but we cannot draw any conclusions about the effect of GH replacement on spine BMD in women with adult-onset GHD.
Snyder
Peter J
PJ
Division of Endocrinology, Diabetes and Metabolism, University of Pennsylvania, Philadelphia, PA 19104-6149, USA. pjs@pobox.upenn.edu
Biller
Beverly M K
BM
Zagar
Anthony
A
Jackson
Ivor
I
Arafah
Baha M
BM
Nippoldt
Todd B
TB
Cook
David M
DM
Mooradian
Arshag D
AD
Kwan
Anita
A
Scism-Bacon
Jamie
J
Chipman
John J
JJ
Hartman
Mark L
ML
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D013006:Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy; D008159:Lumbar Vertebrae / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
D015415:Biomarkers; D013006:Growth Hormone