Growth Hormone and Sex Steroid Effects on Bone Metabolism and Bone Mineral Density in Healthy Aged Women and Men

Christmas, Colleen; O'Connor, Kieran G.; Harman, S. Mitchell; Tobin, Jordan D.; Münzer, Thomas; Bellantoni, Michele; Clair, Carol St.; Pabst, Katharine M; Sorkin, John D.; Blackman, Marc R.

doi:10.1093/gerona/57.1.m12

Cited by 78 publications

(36 citation statements)

References 62 publications

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“…In this group, the pre-existing sex hormone supplement may affected the observed GH effects on bone. One data suggest that short-term administration of hormone replacement therapy (HRT) exerts beneficial effects on bone metabolism and BMD in postmenopausal women, which are not significantly altered by the coadministration of GH; although in andropausal men, testosterone (T) administration to achieve physiologic levels did not result in significant effects on bone metabolism or BMD, whereas GH + T increased one marker of bone formation and decreased one marker of bone resorption [32]. Recent studies shows that oral estrogen reduces hepatic production of IGF-1, while testosterone increases it [33,34].…”

Section: Discussionmentioning

confidence: 99%

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

2009

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Abstract. In order to study the benefit of adding recombinant human growth hormone (rhGH) to antiresorptive therapy, six patients with idiopathic osteoporosis (IO) receiving alendronate plus calcium and vitamin D were started on daily subcutaneous injections of rhGH 2.0 IU for one year. Fasting morning urine and serum samples were collected for N telopeptide of type-1 collagen (NTX), serum bone-specific alkaline phosphatase (BSAP) and insulin-like growth factor 1 (IGF-1) during the study. Bone mineral density (BMD) was determined by dual-energy x-ray absorptiometry at baseline and 01 year. The effect of rhGH was evaluated comparing the percentage changes in BMD during the last year on ALN with the results obtained with the combined therapy. Serum IGF-1 increased in all patients but variations were not significant (p=0.266). Serum BSAP did not significantly change (p=0.078) but median NTX increased at 45 days from 12.3 to 19.8 nMBCE/mMCr (p=0.012) and tended to return to baseline values at 12 months (15.2 nMBCE/mMCr). Comparing with isolated ALN therapy, a beneficial effect on bone density was observed in 2/3 of the patients at lumbar spine, and percentage change (median and quartiles) varied from -0.65% (-2.33 and 2.23) on ALN to 0.70% (-0.35 and 3.03) on ALN+GH. Although no bone gain occurred at the femoral neck, our data point to a positive effect of rhGH in patients with idiopathic osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

2009

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“…Bone is a dynamic tissue that is constantly reshaped by osteoblasts, which build bone, and osteoclasts, which resorb bone. In mammals, reductions in bone density can result from restricted movement and a lack of mechanical stress on bones (disuse osteoporosis- Blouin et al 2007;Resnick 1988), prolonged spaceflight (a special case of disuse osteoporosis- LeBlanc et al 2000;Milstead et al 2004), changes in diet or mineral uptake (Demigne et al 2006;Gennari 2001;RodriguezMartinez and Garcia-Cohen 2002), reductions in baseline concentrations of gonadal steroids and growth hormone (Christmas et al 2002), or changes in life-history stage (Bonnick 2006;Genarri 2001).…”

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confidence: 99%

“…Although little research has been conducted on bone densities of free-living rodents, a large body of clinical evidence suggests that these changes likely have some influence on BMD. In male human subjects, for instance, the interaction of growth hormone and testosterone promotes bone growth, whereas estrogen replacement and growth hormone supplementation have been shown to slow bone loss in menopausal women (Christmas et al 2002). However, growth hormone does not appear to be affected by photoperiod in other tested mammalian species (Bartke et al 1980;Borer et al 1982;Kendall et al 2003;Klemcke et al 1983).…”

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confidence: 99%

Making no Bones About it: Bone Mineral Density Changes Seasonally in a Nonhibernating Alaskan Rodent

Stevenson

Tets

Chon

2009

Journal of Mammalogy

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High-latitude voles and lemmings undergo strong seasonal changes in their behavior and physiology, which may lead to concurrent changes in bone mineral density (BMD). We tested whether the BMD of northern red-backed voles (Myodes rutilus) in Alaska changed seasonally, and if so, whether these changes in their weight-bearing bones were correlated with seasonal changes in photoperiod (a mediator of activity and concentrations of reproductive hormones in high-latitude voles and lemmings), body mass, body length, or a combination of these. We used dual-energy X-ray absorptiometry to measure the BMD of the femur and humerus of voles collected in different seasons. BMDs increased dramatically from the start of spring to their peak level in early summer, and then decreased gradually to their lowest point in late winter. BMDs were significantly lower in fall and winter than in spring and early summer. BMDs of long bones were significantly correlated with both body mass and photoperiod, which accounted for 46.2% and 45.7% of the variation in the BMDs of femur and humerus, respectively. The strong changes that we observed in BMD are likely to be due, in part, to the combined effects of strong seasonal changes in body mass, activity, and baseline levels of reproductive hormones.

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“…(25), em protocolo randomizado, duplo-cego e placebo controlado que envolveu 57 mulheres e 74 homens, 68-88 anos, estudaram os efeitos da reposição de rhGH (0,09mg/kg/semana no início, com redução para 0,08mg/kg/semana) associado ou não a esteróides sexuais, versus placebo por 24 20 e 79 anos (cerca de 30 por década), que o declínio do eixo somatotrófico com o envelhecimento tem um grande impacto na absorção mineral (33). No entanto, embora os protocolos de reposição de GH mostrem elevação dos níveis dos marcadores de formação e de reabsorção óssea, a maior parte dos estudos não demostra efeitos benéficos desta reposição na massa óssea dos idosos (27,34). Existem ainda evidên-cias de que a combinação de rhGH com pamidronato prejudicou o efeito deste agente anti-reabsortivo na densidade óssea (35), e que GH associado à calcitonina mostrou efeito deletério no osso cortical de mulheres menopausadas (36).…”

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Reposição de GH na "somatopausa": solução ou problema ?

Bronstein

2003

Arq Bras Endocrinol Metab

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RESUMOO prolongamento da expectativa de vida tem levado a esforços para que a qualidade de vida e a produtividade dos idosos tornem-se cada vez melhores. Sabe-se que, após o pico puberal, ocorre um declínio progressivo na atividade do eixo GH/IGF-1 com o passar da idade, sendo que, acima dos 60 anos, muitos indivíduos normais apresentam secreção de GH nas 24 horas, indistingüível da dos pacientes adultos com deficiência de GH por lesões hipotálamo-hipofisárias (DGHA). Este fenômeno fisiológico apresenta paralelo com vários aspectos clínicos encontrados na DGHA, tais como aumento da gordura visceral e subcutânea, redução da massa magra, osteoporose, distúrbios neuropsicológicos e psiquiátricos. Como a reposição de GH humano recombinante tem se mostrado útil na reversão desta sintomatologia na DGHA, vários estudos direcionaram o uso de GH para o idoso "saudável", com o intuito de verificar se os mesmos benefícios poderiam ser alcançados. Nesta revisão, procurei analisar os potenciais mecanismos relacionados com o hipo-somatotropismo do idoso, as manifestações clínicas do mesmo, e o resultado dos estudos mais relevantes publicados sobre a reposição de GH no envelhecimento, avaliando os benefícios e os efeitos colaterais. The extension of the life expectancy led to strategies aimed at improving the quality of life and productivity of aging persons. It is well known that, after the pubertal peak, the activity of the GH/IGF-1 axis progressively declines. Consequently, many normal individuals older than 60 years have 24-hour GH secretion indistinguishable from that of an adult patient with GH deficiency due to hypothalamic-pituitary lesions (ADGH). This physiological phenomenon is paralleled with many clinical aspects of ADGH, such as increased visceral and subcutaneous fat, decreased lean mass, osteoporosis, neuropsychological and psychiatric disorders. Since human recombinant GH administration was able to revert such conditions in AGHD, many studies have addressed the issue of GH replacement therapy to the "healthy" elderly in order to assess its potential benefits. This review aims at describing the potential mechanisms related to the somatotrophic axis decline with aging, its clinical manifestations, and the literature addressing GH replacement for the elderly, assessing benefits and side effects.

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Growth Hormone and Sex Steroid Effects on Bone Metabolism and Bone Mineral Density in Healthy Aged Women and Men

Cited by 78 publications

References 62 publications

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

Making no Bones About it: Bone Mineral Density Changes Seasonally in a Nonhibernating Alaskan Rodent

Reposição de GH na "somatopausa": solução ou problema ?

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