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Fracture incidence in GH-deficient patients on complete hormone replacement including GH

In English

Författare

  • Helene Holmer
  • Johan Svensson
  • Lars Rylander
  • Gudmundur Johannsson
  • Thord Rosen
  • Bengt-Ake Bengtsson
  • Marja Thoren
  • Charlotte Hoybye
  • Marie Degerblad
  • Margareta Bramnert
  • Erik Haegg
  • Britt Eden Engstroem
  • Bertil Ekman
  • Karl-Goeran Thorngren
  • Lars Hagmar
  • Eva-Marie Erfurth
Visa allt

Summary, in English

Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential Confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively. Results: A more than doubled risk (IRR, 2.29; 95 % CI 1.23-4.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR, 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54; 95% C1, 0.34-0.86) was recorded in AO GHD men. Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH-IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men.

Publiceringsår

2007

Språk

Engelska

Sidor

1842-1850

Publikation/Tidskrift/Serie

Journal of Bone and Mineral Research

Volym

22

Issue

12

Dokumenttyp

Artikel i tidskrift

Förlag

Wiley-Blackwell

Ämne

  • Endocrinology and Diabetes
  • Environmental Health and Occupational Health

Nyckelord

  • growth hormone therapy
  • hormone deficiency
  • growth
  • pituitary deficiency
  • population study
  • fracture incidence

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1523-4681