title: TRABECULAR BONE SCORE CHANGE DIFFERS WITH REGARD TO 25(OH)D LEVELS IN PATIENTS TREATED FOR ADULT-ONSET GROWTH HORMONE DEFICIENCY.
abstract: OBJECTIVE
  Vitamin D is important in bone health. However, potential relationships of concomitant vitamin D deficiency with growth hormone deficiency (GHD) and the possibility that vitamin D inadequacy may alter the skeletal effects of growth hormone (GH) replacement therapy have not been adequately evaluated.
  
  
  METHODS
  A prospective study was conducted in adult-onset GHD patients treated with recombinant human GH (rhGH) for 2 years. Trabecular bone score (TBS), lumbar spine (LS) bone mineral density (BMD), total hip (TH) BMD, and 25-hydroxyvitamin D (25(OH)D) levels were assessed at baseline and 24 months. The study cohort was divided based on 25(OH)D levels into 2 groups with the cutoff defined as the 50(th) percentile at each follow-up time point.
  
  
  RESULTS
  Fifty-seven patients (29 males/28 females, mean age 34.4 years) were studied. After 24 months of GH replacement, LS BMD increased by 7.6% and TH BMD increased by 4.5% (both P<.05), with no difference according to 25(OH)D levels. TBS increased (+1.39 ± 3.6%) in those whose 25(OH)D was above the 50(th) percentile but decreased (-1.36 ± 5.6%, P<.05) in the cohort below the 50(th) percentile of 25(OH)D. Positive correlations were observed between baseline levels of IGF-1 and 25(OH)D (R = 0.37, P<.001) and between 24-month 25(OH)D and TBS (R = 0.25, P<.05).
  
  
  CONCLUSIONS
  A differential effect of GH on TBS change was observed; TBS increased only in the cohort with 25(OH)D above the 50(th) percentile. Vitamin D sufficiency may be required to obtain optimal effects of GH treatment on bone quality, as assessed by TBS, in GHD adults.
  
  
  BACKGROUND
  AO-GHD = adult-onset GHD BMD = bone mineral density BMI = body mass index Ca = calcium CTx = carboxyterminal collagen crosslinks CV = coefficient of variation DXA = dual energy X-ray absorptiometry ECLIA = enzyme-labeled chemiluminescent immunometric assay GH = growth hormone GHD = growth hormone deficiency IGF-1 = insulin-like growth factor 1 LS BMD = lumbar spine BMD OC = osteocalcin 25(OH)D = 25-hydroxyvitamin D P = phosphorus PTH = parathyroid hormone rhGH = recombinant human GH TBS = trabecular bone score TH BMD = total hip BMD.
authors.forename: Martin
authors.initials: M
authors.lastname: Kužma
authors.forename: Neil
authors.initials: N
authors.lastname: Binkley
authors.forename: Adriana
authors.initials: A
authors.lastname: Bednárová
authors.forename: Zdenko
authors.initials: Z
authors.lastname: Killinger
authors.forename: Peter
authors.initials: P
authors.lastname: Vaňuga
authors.forename: Juraj
authors.initials: J
authors.lastname: Payer
mesh_terms: D000328:Adult; D017668:Age of Onset; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects; D000071556:Cancellous Bone / Q000187:drug effects* / Q000473:pathology; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D