scholarly journals Effects of 3-year GH replacement therapy on bone mineral density in younger and elderly adults with adult-onset GH deficiency

2012 ◽  
Vol 166 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Mariam Elbornsson ◽  
Galina Götherström ◽  
Celina Franco ◽  
Bengt-Åke Bengtsson ◽  
Gudmundur Johannsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Elderly Patients ◽  
Bone Mineral ◽  
The Elderly ◽  
Marginal Effect ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Replacement ◽  
Femur Neck

ObjectiveLittle is known of the effects of long-term GH replacement on bone mineral content (BMC) and bone mineral density (BMD) in elderly GH-deficient (GHD) adults.Design/patients/methodsIn this prospective, single-center, open-label study, the effects of 3-year GH replacement were determined in 45 GHD patients >65 years and in 45 younger control GHD patients with a mean age of 39.5 (s.e.m.1.1) years. All patients had adult-onset disease and both groups were comparable in terms of number of anterior pituitary hormonal deficiencies, gender, body mass index, and waist:hip ratio.ResultsThe mean maintenance dose of GH was 0.24 (0.02) mg/day in the elderly patients and 0.33 (0.02) mg/day in the younger GHD patients (P<0.01). The 3 years of GH replacement induced a marginal effect on total body BMC and BMD, whereas femur neck and lumbar (L2–L4) spine BMC and BMD increased in both the elderly and the younger patients. The treatment response in femur neck BMC was less marked in the elderly patients (P<0.05 vs younger group). However, this difference disappeared after correction for the lower dose of GH in the elderly patients using an analysis of covariance. There were no between-group differences in responsiveness in BMC or BMD at other skeletal locations.ConclusionsThis study shows that GH replacement increases lumbar (L2–L4) spine and femur neck BMD and BMC in younger as well as elderly GHD patients. This supports the notion that long-term GH replacement is also useful in elderly GHD patients.

scholarly journals Baseline Characteristics and Effects of Growth Hormone Therapy over Two Years in Younger and Elderly Adults with Adult Onset GH Deficiency

2006 ◽  
Vol 91 (11) ◽  
pp. 4408-4414 ◽  
Author(s):  
Celina Franco ◽  
Gudmundur Johannsson ◽  
Bengt-Åke Bengtsson ◽  
Johan Svensson
Keyword(s):  
Elderly Patients ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Adult Onset ◽  
Mineral Density ◽  
Open Label ◽  
Gh Replacement ◽  
Waist Hip Ratio ◽  
Baseline Characteristics

Abstract Context: The effects of GH replacement in elderly GH-deficient (GHD) adults are not well known. Objective/Design/Patients: In this prospective, single-center, open-label study, baseline characteristics and the effects of 2-yr GH replacement were determined in 24 GHD adults above 65 yr of age and in 24 younger GHD patients (mean age, 37 yr; range, 27–46 yr). All patients had adult onset disease, and both groups were comparable in terms of the number of pituitary hormonal deficiencies, gender, body mass index, and waist/hip ratio. Duration of hypopituitarism was, however, longer in the elderly patients. Results: The mean maintenance dose of GH was 0.31 (sem, 0.03) mg/d in the elderly GHD patients and 0.44 (0.04) mg/d in the younger patients. The less marked response in IGF-I sd score, total body fat, and extracellular water in the elderly patients lost significance when the dose of GH was accounted for in the statistical analyses. Despite the lower dose in the elderly GHD group, these patients had a more marked reduction in waist/hip ratio and serum low-density lipoprotein-cholesterol level, and these differences remained also after correction for duration of hypopituitarism. There was no difference at baseline or in responsiveness in lean mass, bone mineral density, and glucose homeostasis. Conclusions: This study identifies elderly GHD adults as a GH-sensitive group in whom a low dose of GH can improve body composition and serum lipid profile without any significant impairment of glucose metabolism. GH replacement should therefore be considered in elderly GHD adults.

scholarly journals The correlation of anthropometric parameters and bone mineral density to femur neck fracture risk in elderly population.

2020 ◽  
Vol 27 (03) ◽  
pp. 517-522
Author(s):  
Wajid Akbar ◽  
Humaira Imtiaz ◽  
Usman Ali ◽  
Amna Halima
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Bone Mineral ◽  
The Elderly ◽  
Mineral Density ◽  
Anthropometric Parameters ◽  
T Score ◽  
Femur Neck ◽  
Femur Neck Fracture ◽  
Neck Fracture

Hip fracture is the leading cause of morbidity in the geriatric population of Pakistan. The anthropometric parameters and bone mineral density is closely associated with risks of femur fracture on the elderly. Objectives: This study is oriented upon the relation of anthropometric parameters and bone mineral density with femur neck fracture in the elderly. Study Design: Cross sectional study. Setting: Mardan Medical Complex, Mardan, Pakistan. Period: May 2015 to October 2015. Material & Methods: A total of 121 patients both male and female from 50 to 70 years old were included in the study. Thirty patients had a history of hip fractures while 91 patients were age matched controls. Patients below 40 years and above 70 years were excluded as well as patients on long term steroids, or rheumatoid arthritis and bed ridden. Data regarding patient’s age, sex as well as height and weight were recorded. Both height and weight were measured in light clothing without shoes. Weight was measured using an electronic scale and standing height was measured to the nearest centimeter with a stadiometer. Body mass index was calculated as weight (kg)/height (m).2 Bone mineral density was assisted by Quantitative ultrasound (QUS) heel, using WHO T-score. The Anthropometric parameters and bone mineral density of hip fracture cases were then compared with age-matched control groups. For statistical analysis of data, we used SPSS 20. Results: The average age of hip fracture patients were higher than the control. Females with hip fracture found taller, lighter and had low BMI (p=0.003). Bone mineral density of hip fracture cases were significantly lower as compared to T-score of control (p=0.0001). Height correlated significantly with BMI (r=2.68 p=0.005) and with BMD (r=2.56 p=0.005). Weight had significant correlation with BMI (r= 0.488 p=0.0001) and with BMD (r=0.212 p=0.002). Conclusion: The anthropometric parameter, especially body mass Index and bone mineral density seems to be associated with the risk of femur neck fracture.

scholarly journals Assessment of Total and Regional Bone Mineral Density Using Bioelectrical Impedance Vector Analysis in Elderly Population

2021 ◽  
Author(s):  
Hsueh-Kuan Lu ◽  
Chung-Liang Lai ◽  
Li-Wen Lee ◽  
Lee-Ping Chu ◽  
Kuen-Chang Hsieh
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bioelectrical Impedance ◽  
The Elderly ◽  
Whole Body ◽  
Mineral Density ◽  
Femur Neck ◽  
Impedance Vector ◽  
The Relationship ◽  
Different Levels

Abstract This study aimed to investigate the relationship between bone mineral density (BMD) and height-adjusted resistance (R/H), reactance (Xc/H) and phase angle (PhA). A total of 61 male and 64 female subjects aged over 60 years were recruited from middle Taiwan. The R and Xc were measured using Bodystat Quadscan 4000 at a frequency of 50 kHz. BMD at the whole body, L2-L4 spine, and dual femur neck (DFN), denoted as BMDTotal, BMDL2-L4, and BMDDFN, were calculated using a Hologic DXA scanner. The R-Xc graph was used to assess vector shift among different levels of BMD. BMD was positively correlated with Xc/H and negatively correlated with R/H (p<0.001). The General Linear Model (GLM) regression results were as follows: BMDTotal = 1.473 – 0.002 R/H + 0.007 Xc/H, r = 0.684; BMDL2-L4 = 1.526 – 0.002 R/H + 0.012 Xc/H, r = 0.655; BMDDFN = 1.304 – 0.002 R/H + Xc/H, r = 0.680; p<0.0001. Distribution of vector in the R-Xc graph was significantly different for different levels of BMDTotal, BMDL2-L4 and BMDDFN. R/H and Xc/H were correlated with BMD in the elderly. The linear combination of R/H and Xc/H can effectively predict the BMD of the whole body, spine and proximal femur, indicating that BIVA may be used in clinical and home-use monitoring tool for screening BMD in the elderly in the future.

P24 Fifteen-year GH replacement increases bone mineral density in hypopituitary patients with adult onset GH deficiency

2010 ◽  
Vol 20 ◽  
pp. S48
Author(s):  
M. Elbornsson ◽  
G. Götherström ◽  
B.-Å Bengtsson ◽  
G. Johannsson ◽  
J. Svensson
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Gh Deficiency ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Replacement

scholarly journals Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hsueh-Kuan Lu ◽  
Chung-Liang Lai ◽  
Li-Wen Lee ◽  
Lee-Ping Chu ◽  
Kuen-Chang Hsieh
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bioelectrical Impedance ◽  
The Elderly ◽  
Whole Body ◽  
Mineral Density ◽  
Femur Neck ◽  
Impedance Vector ◽  
The Relationship ◽  
Different Levels

AbstractThis study aimed to investigate the relationship between bone mineral density (BMD) and height-adjusted resistance (R/H), reactance (Xc/H) and phase angle (PhA). A total of 61 male and 64 female subjects aged over 60 years were recruited from middle Taiwan. The R and Xc were measured using Bodystat Quadscan 4000 at a frequency of 50 kHz. BMD at the whole body, L2–L4 spine, and dual femur neck (DFN), denoted as BMDTotal, BMDL2–L4, and BMDDFN, were calculated using a Hologic DXA scanner. The R-Xc graph was used to assess vector shift among different levels of BMD. BMD was positively correlated with Xc/H and negatively correlated with R/H (p < 0.001). The General Linear Model (GLM) regression results were as follows: BMDTotal = 1.473–0.002 R/H + 0.007 Xc/H, r = 0.684; BMDL2–L4 = 1.526–0.002 R/H + 0.012 Xc/H, r = 0.655; BMDDFN = 1.304–0.002 R/H + Xc/H, r = 0.680; p < 0.0001. Distribution of vector in the R-Xc graph was significantly different for different levels of BMDTotal, BMDL2–L4 and BMDDFN. R/H and Xc/H were correlated with BMD in the elderly. The linear combination of R/H and Xc/H can effectively predict the BMD of the whole body, spine and proximal femur, indicating that BIVA may be used in clinical and home-use monitoring tool for screening BMD in the elderly in the future.

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.

scholarly journals Long-term glucocorticoid effect on bone mineral density in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

2016 ◽  
Vol 175 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Filippo Ceccato ◽  
Mattia Barbot ◽  
Nora Albiger ◽  
Marialuisa Zilio ◽  
Pietro De Toni ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Bone Fractures ◽  
Mineral Density ◽  
Hydroxylase Deficiency ◽  
Femur Neck ◽  
21 Hydroxylase Deficiency

Introduction Patients with 21-hydroxylase deficiency (21OHD) assume a lifelong glucocorticoid (GC) therapy. Excessive GC treatment increases the risk of osteoporosis and bone fractures, even though the role of substitutive therapy is not fully established: we analyzed the effect of GC dose on bone metabolism and bone mineral density (BMD) over time in patients with 21OHD. Methods We studied bone metabolism markers and BMD in 38 adult patients with 21OHD (19–47 years, 24 females and 14 males) and 38 matched healthy control. In 15 patients, BMD data were available at both baseline and after a long-term follow-up. Results BMD was lower in patients than in controls at lumbar spine (0.961±0.1g/cm2 vs 1.02±0.113g/cm2, P=0.014) and femur neck (0.736±0.128g/cm2 vs 0.828±0.103g/cm2, P=0.02); otherwise, after height correction, only femoral neck BMD was lower in patients (0.458±0.081g/cm2 vs 0.498±0.063g/cm2, P=0.028). In those 21OHD subjects with at least 10 years follow-up, we observed an increase in lumbar BMD (P=0.0429) and a decrease in femur neck BMD values (P=0.004). Cumulative GC dose was not related to bone metabolism or BMD. No patient experienced clinical fragility fractures. Conclusions BMD values are decreased in patients with 21OHD, which are in part explained by decreased height, but not by the dose of glucocorticoids. Nevertheless, bone status should be carefully monitored in patients with 21OHD.

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