Effect of low-dose of recombinant human growth hormone on bone metabolism in elderly women with osteoporosis

Abstract

Background: There has been increasing evidence that the growth hormone (GH) -IGF-I axis plays an important part in the maintenance of bone mass. However, controversy still exists as to the effect of GH treatment on bone mineral density (BMD) in elderly patients with osteoporosis. Objective: To investigate the effect of low-dose GH treatment on markers of body composition and bone turnover, serum concentrations of IGF-I and IGF-binding proteins (IGFBPs), and BMD at the radius and lumbar spine in eight elderly Japanese women with osteoporosis. Methods: Participants were treated with GH as a single daily subcutaneous injection (0.125 IU/kg per week; 0.00595 mg/kg per day) for 48 weeks. Results: Markers of bone formation and bone resorption were both increased up to 24 weeks of GH treatment. The bone formation markers remained increased during GH treatment, whereas the bone resorption markers returned to baseline values after 24 weeks of GH treatment. GH treatment caused a rapid (within 2 weeks) and sustained increase in serum IGF-I concentration. As for IGFBPs, serum concentrations of IGFBPs-2, -3 and -4 did not change significantly during GH treatment. In contrast, GH treatment caused a gradual increase in serum IGFBP-5 concentration, with a significant increase seen 48 weeks after the start of GH treatment. Radial BMD seemed to be increased during the late period of GH treatment, although the change was not significant. Lumbar BMD did not change during GH treatment. GH treatment caused a significant increase in hand grip strength. None of the GH-treated participants had new fractures and side effects such as edema and joint pain. Radial BMD was significantly increased after discontinuation of GH treatment for another 48 weeks and a similar tendency was observed at the lumbar spine (7:1^2:3% above pretreatment values for the radius and 3:6^2:0% for the lumbar spine). Conclusions: Low-dose GH treatment attenuated the decrease in muscle strength and bone mass in elderly women without side effects, although changes in nutrition and exercise might affect BMD. The present findings provide useful information regarding the use of low-dose GH treatment in elderly women with osteoporosis.

Osteoporosis

“…The response to GH may differ in diverse clinical situations (ie, hypopituitarism, Shehan syndrome, postmenopause, idiopathic osteoporosis in men, children). 130,132,[154][155][156][157][158][159][160][161][162][163] In an earlier meta-analysis, fluoride, a mineral that is incorporated into bone, increased the risk of fractures when administered in high doses but reduced fractures at low doses. [164][165][166][167][168][169] Fluoride is approved as an osteoporosis therapy in Europe but not in the United States.…”

Functional Characterization of Des-IGF-1 Action at Excitatory Synapses in the CA1 Region of Rat Hippocampus

“…These studies revealed that agerelated decreases in lean muscle mass, bone mass, immune function, and skin thickness are ameliorated by growth hormone administration (Andersen et al 2000;Davila et al 1987;Rudman et al 1990;Sonntag et al 1985;Sugimoto et al 2002). However, the effects of growth hormone replacement on the aging brain are only beginning to be understood.…”

A case of myxedema coma caused by isolated thyrotropin stimulating hormone deficiency and Hashimoto's thyroiditis

“…It is established that GH-IGF-I axis is crucial factor for the maintenance of normal bone mass [14]. However, serum markers for bone remodeling are usually decreased in patients with GH deficiency [15] whereas our patient showed increased turnover of bone metabolism. Otherwise, immobility can also negatively affect a patient's BMD [16].…”