scholarly journals SUN-348 Growth Hormone Replacement in Adults During 8 Years Leads to Sustained Increase in Bone Mineral Density

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Juraj Payer ◽  
Martin Kužma ◽  
Daša Stojkovičová ◽  
Juraj Smaha ◽  
Peter Jackuliak ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Growth Hormone ◽  
Bone Mass ◽  
Bone Turnover ◽  
Single Center ◽  
Mineral Density ◽  
Gh Replacement ◽  
Turnover Markers

Abstract Introduction: Adult growth hormone deficiency (AGHD) is associated with lower bone mass and likely with increased risk of fragility fractures. GH replacement leads to increase in bone mineral density (BMD).However, only few studies longer than 2 years exist. Aim: To assess long-term effect of recombinant GH replacement on BMD and bone turnover markers duringperiod of 8 years. Patients & Methods: Prospective follow-up of all (N=63) AGHD patients at one single center. All patients with adult GHD followed at single center. All participants were replaced with daily injection of recombinant human (rh) GH in IGF-1 normalizing regimen according to Endocrine Society Guidelines. Every 2 years, lumbar spine (L-spine) and total hip (TH) BMD using dual X-ray absorptiometry on Hologic Discovery device, was assessed. All patients were assessed for bone turnover markers; carboxy-terminal collagen crosslinks (CTx) and osteocalcin (OC), and 25(OH)D levels. Deficiencies of other pituitary axes were treated if necessary. All patients were supplemented with 800 IU /day of cholecalciferol and 1000-1200mg/day of calcium as recommended by International Osteoporosis Foundation. Results: Study group consisted of 38 males and 25 females (35 with adult onset (AO) /28 with childhood onset (CO); mean age at diagnosis 25,1 yrs) AGHD patients. All patients ended 8 years follow-up period without any treatment discontinuation during this period. Treatment was well tolerated, without any serious adverse event. IGF-1 has reached the normal ranges during first 6 months and remains normal during whole study period documenting good adherence to treatment (average dose of rhGH=0,4 mg/day). Both, L-spine and TH BMD increased significantly after 8 years of GH replacement (+8 % for L-spine BMD, +7,7% for TH BMD, both p<0,01). The highest peak of BMD was observed after 6 years of treatment. CTx increased by 35% (p<0,05) and remain stable, and no significant change in OC was observed during study period. Levels of 25(OH)D increased by 32% (p<0,05) from baseline. No clinical fractures were observed. Conclusion: Long-term GH replacement in adult GHD together with sufficient levels of vitamin D levels led to increase in BMD and CTx. This study supported fact that GH has sustained effect on bone mass and bone turnover and is safe and well -tolerated for the long time period.

scholarly journals The Long-Term Effects of Growth Hormone Replacement on Bone Mineral Density and Trabecular Bone Score: Results of the 10-Year Prospective Follow-up

2021 ◽  
pp. S61-S68
Author(s):  
P. Vaňuga ◽  
M. Kužma ◽  
D. Stojkovičová ◽  
J. Smaha ◽  
P. Jackuliak ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Growth Hormone ◽  
Trabecular Bone ◽  
Replacement Therapy ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Gh Replacement

There are only few studies concerning about long-term effect of growth hormone (GH) replacement therapy on bone mineral density and bone microstructure. To assess effect of GH replacement therapy on bone mineral density (BMD) and trabecular bone score (TBS) in adult GH deficient (AGHD) subjects over period of 10 years. From 2005 to 2018, a prospective study of AGHD patients was conducted in national referral center for treatment of GHD. All patients received subcutaneous recombinant human GH in an IGF 1-normalizing regimen once a day. Lumbar spine (L-spine) and total hip (TH) BMD using Hologic densitometers were measured at baseline and every two years during treatment with rhGH. TBS was derived from L1-L4 DXA using iNsight® software (Medimaps, France) at each time point. Periods of measurement were baseline, year 2; 4; 6; 8 and 10. In total, 63 patients (38 males, 25 females, mean age 25.1±16 years) were included in the study. After 10 years of GH treatment, IGF-1 significantly increased (~35 %), with greatest increase at year 2. During 10-year follow-up, L-spine BMD increased approximately of 7 % (NS). TH BMD increase of 11 % during follow-up (p=0.0003). The greatest increment of BMD was achieved at year 6 on both sites, L-spine (+6 %) and TH BMD (+13 %) (p<0.05). There was no significant change of TBS during whole follow-up. In this study, sustaining positive effect of GH replacement therapy on bone density in subjects with adult GH deficiency over 10 years of follow-up was observed. The study did not show effect on TBS, as indirect measure of trabecular bone microarchitecture.

Bone mineral density and bone turnover markers in patients with thyroid cancer and L-T4 suppressive therapy after 25 years of follow-up

2014 ◽  
Author(s):  
Mingo Dominguez Maria Luisa de ◽  
Sonsoles Guadalix Iglesias ◽  
Maria Begona Lopez Alvarez ◽  
Guillermo Martinez Diaz-Guerra ◽  
Federico Hawkins Carranza
Keyword(s):  
Bone Mineral Density ◽  
Thyroid Cancer ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Suppressive Therapy ◽  
Mineral Density ◽  
Turnover Markers

scholarly journals Observational Study to Evaluate the Effect of Epidural Steroid Injection on Bone Mineral Density and Bone Turnover Markers

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E517-E524
Author(s):  
Paras Gupta
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Mineral Density ◽  
Turnover Markers ◽  
Epidural Steroid

Background: Epidural steroid injection (ESI) is widely used to manage low back pain. ESIs are commonly performed to treat pain accompanying intervertebral disc prolapse, spinal stenosis, facet joint pathologies, and other degenerative spinal pathologies. Corticosteroids for musculoskeletal conditions, regardless of the route of administration, can reduce bone mineral density (BMD) and increase the risk of fracture. With paraspinal administration of steroids, the severity of risk is enhanced as the steroid is being deposited in close proximity to bone. BMD and molecular markers of bone metabolism are the standard methods to assess the effect of any insult on bone strength and bone metabolism. Carboxy terminal crosslinked telopeptides of type 1 collagen (sCTX) and serum Procollagen Type I N-terminal propeptide (P1NP) are the reference markers of bone resorption and formation, respectively. Objective: We conducted this study to determine the effect of ESI on BMD and bone turnover markers. Study Design: This was a prospective observational cohort study, involving a cohort of 264 patients between the ages of 40 to 60 years who were advised to undergo ESI at L3-4 or L4-5 by their pain physician. Setting: Research was conducted at a tertiary care teaching hospital pain clinic in collaboration with the department of orthopaedics and radiodiagnosis. Methods: Serum CTX-1, P1NP, and pre-ESI BMD of the spine, femur neck, and dual femur were evaluated at baseline; these same parameters were serially evaluated post ESI on follow-ups at 1, 3, and 6 months. Additional follow-up at 10 days post ESI was called for evaluation of bone turnover markers (BTMs). A paired t test was used to analyze changes in BMD and BTMs vs baseline within the group. Cumulative incidence and relative risk of moderate to markedly low BMD were calculated using standard formulas. Any fractures sustained during follow-ups were also evaluated thoroughly and quantified separately. A P value less than .05 was considered statistically significant. Results: The proportion of pre-ESI moderately to markedly low BMD was 10.22% in the study population. There was a statistically significant increase in serum CTX 10 days post ESI which persisted at the one-month and 3-month follow-ups. There was no significant change in serum P1NP level post ESI after 7 days and at the one-month follow-up. The mean value of serum P1NP was, however, significantly higher at the 3-month follow-up. Statistical comparison of the mean BMD value at the spine and femur neck revealed statistically significant decline 3 months post ESI. There was no significant impact of ESI on the total femur BMD. The cumulative incidence of moderately low to markedly low BMD over a period of 6 months in the study population was 45 out of 223, i.e., 20.17%. Limitations: The study’s primary limitations included its high dropout rate, a larger reference range for BTMs, making them a less specific tool for comparison, and the absence of a control group. ESI has a negative impact on the BMD of the hip and spine. Reduced BMD should be considered as a potential side effect of ESI. Key words: Bone mineral density, bone turnover markers, epidural steroid injection, low back ache, osteoporosis Pain Physician 202

Bone Mineral Density and Biochemical Markers of Bone Metabolism in Women Engaging in Recreational Horseback Riding

2016 ◽  
Vol 13 (5) ◽  
pp. 520-524 ◽  
Author(s):  
Agnieszka Kaczmarek ◽  
Alicja Nowak ◽  
Piotr Leszczynski
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Horseback Riding ◽  
Mineral Density ◽  
Turnover Markers

Background:An increased occurrence of lifestyle-related diseases such as osteoporosis indicates the necessity for taking preventive action, including regularly engaging in physical activity. The aim of the study was to assess the areal bone mineral density (aBMD) and bone turnover markers levels in young adult women engaging in recreational horseback riding and to determine the relationship between training characteristics and bone metabolism indices.Methods:The study involved 43 women: 23 equestrians and 20 age- and body mass index–matched controls. The hip and spine aBMD and serum levels of the bone turnover markers: osteocalcin and collagen type I cross-linked C-telopeptide were measured.Results:No significant differences were found in somatic features, concentrations of bone turnover markers, or bone mass variables. Correlation analysis of the equestrian participants showed significant relationship between body mass and BMDL1–L4 (P < .05) as well as between BMI and BMDL1–L4 (P ≤ .01) and z-score L1–L4 (P < .05).Conclusions:The study showed no differences in bone mass and levels of bone metabolic indices between groups of women practicing horseback riding at the recreational level and subjects who do not participate in frequent systematic physical activity. No relationship between training characteristics and bone turnover markers were found.

Effect of early risedronate treatment on bone mineral density and bone turnover markers after liver transplantation: a prospective single-center study

2011 ◽  
Vol 24 (7) ◽  
pp. 657-665 ◽  
Author(s):  
Sonsoles Guadalix ◽  
Guillermo Martínez-Díaz-Guerra ◽  
David Lora ◽  
Carmela Vargas ◽  
Miren Gómez-Juaristi ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Transplantation ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Single Center ◽  
Mineral Density ◽  
Single Center Study ◽  
Turnover Markers ◽  
Center Study
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