Bone Mineral Density and Body Composition in Adolescents with Childhood-Onset Growth Hormone Deficiency

Boot, Annemieke M.; Sluis, Inge M. van der; Krenning, Eric P.; Keizer‐Schrama, Sabine M.P.F. de Muinck

doi:10.1159/000223422

Cited by 26 publications

(25 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reduced BMD in the CP women is in accordance with a previous study showing increased fracture incidence in CO GHD women, but not in CO GHD men on long-term GH therapy (12). Contributing factors might be late-onset puberty resulting in later than optimal introduction of sex steroids.…”

Section: Discussionsupporting

confidence: 90%

“…Seven women had menarche at 12 (10)(11)(12)(13)(14) years, but five of them had amenorrhea periods from 1 ⁄ 2 to 3 years thereafter. The remaining 13 women had puberty induction at 15 (12-18) years of age.…”

Section: Patientsmentioning

confidence: 99%

“…In adults with childhood onset (CO) GH deficiency (GHD), BMD is often reduced compared with healthy controls (11,12), and a discontinuation of GH therapy at final height and before achievement of peak bone mass (11) is a possible contributing factor. Whether continuous GH therapy in CO GHD will result in a normalization of BMD is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma

Holmer

Popović²,

Ekman³

et al. 2011

European Journal of Endocrinology

View full text Add to dashboard Cite

Context: Data on bone mineral density (BMD) are lacking in adults with childhood onset (CO)-craniopharyngioma (CP) with hypothalamic damage from the tumor. In patients with CO GH deficiency, BMD increases during GH treatment. Objective: The aims were to evaluate BMD in adults with CO-CPs on complete hormone replacement, including long-term GH and to evaluate the impact of hypothalamic damage on these measures. Design and participants: BMD (dual-energy X-ray absorptiometry), markers of bone turn over, physical activity and calcium intake were assessed in 39 CO-CP adults (20 women), with a median age of 28 (17-57) years, in comparison with matched population controls. Results: Late puberty induction was recorded in both genders, but reduced androgen levels in females only. Only CP women had lower BMD (PZ0.03) at L2-L4, and reduced Z-scores at femoral neck (PZ0.004) and L2-L4 (PZ0.004). Both genders had increased serum leptin levels (PZ0.001), which significantly correlated negatively with BMD at L2-L4 (PZ0.003; rZK0.5) and 45% of CP women had Z-score levels %K2.0 S.D. Furthermore, 75% of those with a Z-score %K2.0 S.D. had hypothalamic involvement by the tumor. Calcium intake (PZ0.008) and physical activity (PZ0.007) levels were reduced in CP men only. Levels of ostecalcin and crossLaps were increased in CP men only. Conclusions: Despite continuous GH therapy, low BMD was recorded in CO-CP females. Insufficient estrogen and androgen supplementation during adolescence was the main cause, but hypothalamic involvement with consequent leptin resistance was also strongly associated with low BMD in both genders.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma

Holmer

Popović²,

Ekman³

et al. 2011

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…In adults with CO GH deficiency (GHD), bone mineral density (BMD) is reduced compared to healthy control subjects (40,41) and discontinuation of GH therapy before achievement of peak bone mass may be the cause (42).…”

Section: Bone Healthmentioning

confidence: 99%

Endocrine aspects and sequel in patients with craniopharyngioma

Erfurth

2015

Journal of Pediatric Endocrinology and Metabolism

View full text Add to dashboard Cite

A craniopharyngioma (CP) is an embryonic malformation of the sellar and parasellar region. The annual incidence is 0.5-2.0 cases/million per year and approximately 60% of CP is seen in adulthood. The therapy of choice is surgery, followed by cranial radiotherapy in about half of the patients. Typical initial manifestations at diagnosis in children are symptoms of elevated intracranial pressure, visual disturbances and hypopituitarism. CPs have the highest mortality of all pituitary tumours. The standardised overall mortality rate varies from 2.88 to 9.28 in cohort studies. Adults with CP have a 3-19-fold higher cardiovascular mortality in comparison to the general population. Women with CP have an even higher risk. The long-term morbidity is substantial with hypopituitarism, increased cardiovascular risk, hypothalamic damage, visual and neurological deficits, reduced bone health and reduction in quality of life and cognitive function.

show abstract

“…Only few studies have assessed bone mineral density (BMD) in girls treated with GnRHa for CPP, showing minimal [10, 23-26] or no changes in BMD parameters, both during treatment and later in life [27]. …”

Section: Introductionmentioning

confidence: 99%

Metabolic Outcomes, Bone Health, and Risk of Polycystic Ovary Syndrome in Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues

Faienza

Brunetti

Acquafredda³

et al. 2017

Horm Res Paediatr

View full text Add to dashboard Cite

Background/Aims: Gonadotropin-releasing hormone analogues (GnRHa) represent the gold standard treatment for central precocious puberty (CPP). We aimed to assess the effects of GnRHa treatment on metabolic outcomes, bone status, and polycystic ovary syndrome (PCOS) prevalence in young girls with idiopathic CPP (ICPP). Methods: We enrolled 94 ICPP girls who were at least 2 years after menarche and had already attained adult height at the time of the study: 56 previously treated with depot triptorelin (3.4 ± 0.6 years) and 38 untreated. Auxological parameters, lipid profile, homeostatic model assessment of insulin resistance (HOMA-IR), bone state, and prevalence of PCOS were assessed. Results: The 2 groups were similar for body mass index (BMI) and waist circumference. HOMA-IR, dehydroepiandrosterone sulfate, and Δ4-androstenedione were higher in the treated than in the untreated subjects (p < 0.001). Significant differences were found for amplitude-dependent speed of sound (p < 0.03) and bone transmission time z-scores (p < 0.01). The prevalence of PCOS was higher in the treated than in the untreated subjects (p < 0.04). Conclusion: GnRHa therapy is associated with hyperandrogenism and an increase in insulin resistance and PCOS prevalence, but not with increased BMI or lipid profile alterations. Long-term evaluations at the time of expected peak bone mass achievement are needed to understand the persistent or transient nature of subtle bone abnormalities.

show abstract

Bone Mineral Density and Body Composition in Adolescents with Childhood-Onset Growth Hormone Deficiency

Cited by 26 publications

References 92 publications

Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma

Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma

Endocrine aspects and sequel in patients with craniopharyngioma

Metabolic Outcomes, Bone Health, and Risk of Polycystic Ovary Syndrome in Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues

Contact Info

Product

Resources

About