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Growth hormone effects on cortical bone dimensions in young adults with childhood-onset growth hormone deficiency . UNLABELLED Growth hormone ( GH ) treatment in young adults with childhood-onset GH deficiency has beneficial effects on bone mass . The present study shows that cortical bone dimensions also benefit from GH treatment , with endosteal expansion and increased cortical thickness leading to improved bone strength . INTRODUCTION In young adults with childhood-onset growth hormone deficiency ( CO GHD ) , GH treatment after final height is reached has been shown to have beneficial effects on spine and hip bone mineral density . The objective of the study was to evaluate the influence of GH on cortical bone dimensions . METHODS Patients ( n = 160 ; mean age , 21.2 years ; 63 % males ) with CO GHD were randomised 2:1 to GH or no treatment for 24 months . Cortical bone dimensions were evaluated by digital x-ray radiogrammetry of the metacarpal bones every 6 months . RESULTS After 24 months , cortical thickness was increased compared with the controls ( 6.43 % , CI 3.34 to 9.61 % ; p = 0.0001 ) and metacarpal index ( MCI ) ( 6.14 % , CI 3.95 to 8.38 % ; p < 0.0001 ) , while the endosteal diameter decreased ( -4.64 % , CI -7.15 to -2.05 ; p < 0.001 ) . Total bone width did not change significantly ( 0.68 % , CI -1.17 to 2.57 % ; not significant ( NS ) ) . A gender effect was seen on bone width ( p < 0.0001 ) , endosteal diameter ( p < 0.01 ) and cortical thickness ( p < 0.01 ) , but not with MCI ( NS ) . CONCLUSIONS Cortical bone reacts promptly to reinstitution of GH beyond the attainment of final height by increasing the cortical thickness through endosteal bone growth . This leads to a higher peak bone mass and may reduce the risk of cortical bone fragility later in life .
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Intervention_Physical
Growth hormone ( GH ) treatment
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Outcome_Physical
cortical bone dimensions
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Outcome_Physical
bone mass
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Outcome_Physical
improved bone strength
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Outcome_Physical
GH
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Outcome_Physical
cortical bone dimensions