Focus on growth hormone deficiency and bone in adults

Tritos, Nicholas A.

doi:10.1016/j.beem.2017.02.002

Cited by 24 publications

(13 citation statements)

References 64 publications

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“…Pituitary hormones directly or indirectly modulate bone metabolism and re modeling and are essential for optimal bone homeostasis [7]. Management of pituitary hypersecretion through surgery, medical therapy and/or radiation therapy, and treatment of anterior pituitary deficiency of gonadotro pins and in some cases growth hormone, are typically addressed as the main reversible causes of low bone mineral density (BMD) in these patients [8,9]. Although appropriate hormone replacement results in a sustained increase in BMD at longterm followup [3,[10][11][12], some patients remain at high risk for fractures and require pharmacological therapies to treat low BMD [7].…”

Section: Introductionmentioning

confidence: 99%

Lower Oxytocin Levels Are Associated with Lower Bone Mineral Density and Less Favorable Hip Geometry in Hypopituitary Men

Aulinas¹,

Guarda²,

Yu³

et al. 2020

Neuroendocrinology

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Introduction: Hypopituitary patients are at risk for bone loss. Hypothalamic-posterior pituitary hormones oxytocin and vasopressin are anabolic and catabolic, respectively, to the skeleton. Patients with hypopituitarism may be at risk for oxytocin deficiency. Whether oxytocin and/or vasopressin contribute to impaired bone homeostasis in hypopituitarism is unknown. Objectives: To determine the relationship between plasma oxytocin and vasopressin levels and bone characteristics (bone mineral density [BMD] and hip structural analysis [HSA]) in patients who have anterior pituitary deficiencies only (APD group) or with central diabetes insipidus (CDI group). Methods: This is a cross-sectional study. Subjects included 37 men (17 CDI and 20 APD), aged 20–60 years. Main outcome measures were fasting plasma oxytocin and vasopressin levels, and BMD and HSA using dual X-ray absorptiometry. Results: Mean BMD and HSA variables did not differ between the CDI and APD groups. Mean BMD Z-scores at most sites were lower in those participants who had fasting oxytocin levels below, rather than above, the median. There were positive associations between fasting oxytocin levels and (1) BMD Z-scores at the spine, femoral neck, total hip, and subtotal body and (2) favorable hip geometry and strength variables at the intertrochanteric region in CDI, but not APD, participants. No associations between vasopressin levels and bone variables were observed in the CDI or ADP groups. Conclusions: This study provides evidence for a relationship between oxytocin levels and BMD and estimated hip geometry and strength in hypopituitarism with CDI. Future studies will be important to determine whether oxytocin could be used therapeutically to optimize bone health in patients with hypopituitarism.

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Section: Introductionmentioning

confidence: 99%

Lower Oxytocin Levels Are Associated with Lower Bone Mineral Density and Less Favorable Hip Geometry in Hypopituitary Men

Aulinas¹,

Guarda²,

Yu³

et al. 2020

Neuroendocrinology

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“…To our knowledge, even though the underlying mechanism between sleep duration and osteoporosis risk is not fully understood, the decrease in melatonin [23] and growth hormone (GH) [24], and the increase in glucocorticoids [25] and inflammatory cytokines [26,27] resulted from inadequate sleep which could play an important role. First, a randomized controlled trial (RCT) [28] found that treatment with melatonin increased BMD while the same result was observed in an animal study [29], another RCT [30] indicated that GH treatment in postmenopausal osteoporosis reduced the fracture incidence by 28% during the 10 years follow-up, and Tritos' analysis [31] also suggested that GH treatment was associated with decreased fracture risk in adults. Then, two studies [32,33] presented that elevated circulating glucocorticoids reduced the osteoblast function while the two other studies [34,35] demonstrated that increased circulating inflammatory cytokines had the same effect.…”

Section: Discussionmentioning

confidence: 90%

The associations between different sleep patterns and osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians

Wang

Guo

et al. 2020

Arch Osteoporos

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Summary Based on the use of Osteoporosis Self-Assessment Tool for Asians (OSTA) to assess osteoporosis risk, we found that short sleep duration and taking a daytime nap had an increased risk of osteoporosis. Purpose To explore the associations between different sleep patterns with osteoporosis. Methods 3659 postmenopausal women (average age of 60 years) were divided into low, middle, and high osteoporosis risk categories based on the Osteoporosis Self-Assessment Tool for Asians (OSTA). After having collected by a standard questionnaire, total and nocturnal sleep duration was collapsed to form categories of ≤ 6 h, > 6 h and ≤ 7 h, > 7 h and ≤ 8 h, > 8 h and ≤ 9 h, > 9 h, and daytime nap duration of 0 h and > 0 h. Results As a categorical variable, the total sleep duration of ≤ 6 h per day (OR = 1.34, 95% CI 1.04–1.72), nocturnal sleep duration of ≤ 6 h per night (OR = 1.65, 95% CI 1.24–2.18), and taking a daytime nap (OR = 1.33, 95% CI 1.09–1.64) had higher osteoporosis risk after adjustment for covariates. As a continuous variable, after the adjustment for covariates, both longer total (OR = 0.86, 95% CI 0.78–0.94) and nocturnal sleep duration (OR = 0.83, 95% CI 0.76–0.91) had lower risk of osteoporosis risk while taking longer daytime nap (OR = 1.10, 95% CI 1.02–1.19) had higher osteoporosis risk. Conclusions Postmenopausal women with both short total and nocturnal sleep duration (6 h or less) and taking a daytime nap had increased osteoporosis risk as assessed by OSTA.

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“…Cranial irradiation in children is a known risk factor for later pituitary malfunctions [31], among others, growth hormone deficiency (GHD) and hypogonadism. Adults with untreated adult-onset GHD have decreased BMD, and adults with childhood-onset GHD have in some, but not all, studies been reported to have lower BMD than controls [32]. Bone mineral density increases after more than 1 year of growth hormone replacement in adults with GHD [27].…”

Section: Discussionmentioning

confidence: 98%

Low bone mineral density is associated with hypogonadism and cranial irradiation in male childhood cancer survivors

et al. 2020

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We investigated if bone mineral density was related to testosterone deficiency and/or previous cancer treatment in men who were childhood cancer survivors. Men with untreated testosterone deficiency or previous treatment with cranial irradiation were at increased risk of impaired bone health. Prevention of osteoporosis should be considered in their follow-up. Introduction Childhood cancer survivors (CCS) are at increased risk of hypogonadism. Reduced bone mineral density (BMD) has been reported in CCS but it is unclear whether this is due to hypogonadism or a direct effect of cancer therapy. This study investigated BMD in CCS, and association with hypogonadism, previous treatment and cancer type. Methods Investigation of 125 CCS (median age 33.7 at inclusion; 9.6 at diagnosis) and 125 age-matched population controls. Serum testosterone and luteinizing hormone were assayed and BMD at total hip and lumbar spine L1-L4 measured. The mean difference in BMD (g/cm 2 ; 95% CI) between CCS and controls was analysed. Odds ratios (OR; 95% CI) for low BMD were also calculated. Results Overall, BMD in the CCS cohort did not significantly differ from controls. However, compared with eugonadal CCS, the CCS with untreated hypogonadism had lower BMD at the hip (mean difference − 0.139 (− 0.210; − 0.067); p < 0.001) and spine (− 0.102 (− 0.174; − 0.030); p = 0.006). They also had a higher risk of low hip BMD (OR 4.1 (1.3; 14); p = 0.018). CCS treated with cranial irradiation also had lower BMD (hip − 0.076 (− 0.133; − 0.019); p = 0.009; spine − 0.071 (− 0.124; − 0.018); p = 0.009) compared with controls. The latter associations remained statistically significant after adjustment for hypogonadism. Conclusions CCS with hypogonadism or previously treated with cranial irradiation are at increased risk of impaired bone health. Prevention of osteoporosis should be considered as an important part in future follow-up of these men.

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Focus on growth hormone deficiency and bone in adults

Cited by 24 publications

References 64 publications

Lower Oxytocin Levels Are Associated with Lower Bone Mineral Density and Less Favorable Hip Geometry in Hypopituitary Men

Lower Oxytocin Levels Are Associated with Lower Bone Mineral Density and Less Favorable Hip Geometry in Hypopituitary Men

The associations between different sleep patterns and osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians

Low bone mineral density is associated with hypogonadism and cranial irradiation in male childhood cancer survivors

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