A longer interval without GH replacement and female gender are associated with lower bone mineral density in adults with childhood-onset GH deficiency: a KIMS database analysis.
OBJECTIVE
Childhood-onset GH deficiency (COGHD) is associated with low bone mineral density (BMD). Adults with persistent COGHD may be at risk for insufficient bone accrual or bone loss during adulthood. The purpose of this study was to identify BMD predictors and to characterize the effects of GH replacement on BMD in COGHD adults with persistent GHD.


METHODS
Retrospective analysis of the KIMS database.


METHODS
Variables predicting standardized BMD (sBMD) were identified. The effect of GH replacement (3 years) on BMD was examined.


RESULTS
Three hundred and fourteen COGHD adults (148 women, 166 men; 62 non-naïve, 178 semi-naïve, and 74 true naïve, depending on length and timing of previous GH replacement), who had BMD measured in lumbar spine (LS) and femoral neck (FN) at study entry. In semi-naïve subjects, a longer gap in GH replacement between childhood and adulthood was predictive of lower sBMD in the FN (r=-0.18, P=0.038). TSH deficiency predicted lower sBMD in the LS (r=-0.16, P=0.052). In true naïve patients, a longer gap between onset of pituitary disease and study entry (r=-0.35, P=0.012), and female gender (r=-0.27, P=0.043) independently predicted lower sBMD in the FN. There were no differences in BMD increases between non-naïve, semi-naïve, and true naïve subjects on GH replacement.


CONCLUSIONS
In semi-naïve subjects a longer interval off GH replacement was associated with lower sBMD in the FN. Among true naïve patients, a longer gap between the onset of pituitary disease and GH replacement, and female gender predicted lower sBMD in the FN.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Zero Emerson Place, Suite 112, Boston, Massachusetts 02114, USA. ntritos@partners.org
Nicholas A
NA
Tritos
Amir H
AH
Hamrahian
Donna
D
King
Susan L
SL
Greenspan
David M
DM
Cook
Peter J
PJ
Jönsson
Michael P
MP
Wajnrajch
Maria
M
Koltowska-Häggstrom
Beverly M K
BM
Biller
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004393:Dwarfism, Pituitary / Q000188:drug therapy* / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
D019382:Human Growth Hormone