Effects of Recombinant Human Growth Hormone in Children with Crohn’s Disease on the Muscle-Bone Unit: A Preliminary Study

Abstract

Background/Aims: There is limited information on the impact of recombinant human growth hormone (rhGH) on the muscle-bone unit in children with Crohn’s disease (CD). In this pilot study, we report on the effects of rhGH on bone formation, dual-energy X-ray absorptiometry (DXA) total body (TB) bone mineral density adjusted for height and lumbar spine (LS) bone mineral apparent density (BMAD), and body composition. Methods: Prospective study of 8 children with CD (6 male), aged 14.8 years (9.0–16.4), who received rhGH for 24 months. Serum procollagen type 1 N-terminal propeptide (P1NP) was measured at baseline and at 6 months. DXA was performed every 6 months. Results: Six months of rhGH led to improvement in P1NP SDS adjusted for bone age from –3.6 (–7.9 to –0.9) to –2.4 (–3.7 to 0.4) (p = 0.01). At baseline, reduction in LS-BMAD and TB lean mass SDS was observed being –1.2 (–3.6 to 0.8) (p = 0.01 vs. zero) and –0.8 (–2.4 to 3.0) (p = 0.11 vs. zero), respectively. No significant changes were seen in DXA bone and muscle parameters over the 24 months. Conclusion: Twenty-four months of therapy with rhGH in CD did not lead to an improvement in DXA BMD and lean mass, despite improvement in P1NP and linear growth.

Research advances in crosstalk between muscle and bone in osteosarcopenia (Review)

“…In the aging process, the levels of GH and IGF-1 show a notable downward trend ( 162 ). Recombinant human GH therapy works by affecting systemic GH and IGF-1 levels, which in turn improves physical function, muscle mass and bone density ( 163 ). However, a number of studies have also reported adverse reactions, including carpal tunnel syndrome, peripheral edema, joint pain and swelling, enhanced female breast development, impaired glucose tolerance and increased cancer risk ( 164 ).…”