Issues related to secondary osteoporosis associated with growth hormone deficiency in adulthood

Česká verzia

Authors: Martin Kužma ¹; Peter Jackuliak ¹; Zdenko Killinger ¹; Peter Vaňuga ²; Juraj Payer ¹
Authors place of work: V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava, Slovenská republika ¹; Národný endokrinologický a diabetologický ústav, Ľubochňa, Slovenská republika ²
Published in the journal: Vnitř Lék 2017; 63(10): 658-661
Category: Reviews

Summary

Growth hormone (GH) increases linear bone growth through complex hormonal reactions, mainly mediated by insulin like growth factor 1 (IGF1) that is produced mostly by hepatocytes under influence of GH and stimulates differentiation of epiphyseal prechondrocytes. IGF1 and GH play a key role in the linear bone growth after birth and regulation of bone remodelation during the entire lifespan. It is known that adult GH deficient (GHD) patients have decreased BMD and increased risk of low-impact fractures. Most data gathered thus far on the effect of GH replacement on bone status comprise the measurement of quantitative changes of bone mass. Some animal studies with GHD showed that the bone microarchitecture, measured using computed tomography methods, is significantly compromised and improve after GH replacement. However, human studies did not show significantly decreased bone microarchitecture, but limited methodological quality does not allow firm conclusions on this subject.

Key words:
bone mass – bone quality – fracture – growth hormone – IGF1

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