ADULT GROWTH-HORMONE DEFICIENCY AND BONE MASS

Bone mineral density (BMD) is reduced in adults with growth hormone (G H) deficiency and the decrease in BMD appears more marked if the GH de ficiency is childhood onset rather than adult onset. Recent epidemiolo gical studies suggest an increased fracture rate in GH-deficient adult s. The skeletal response to GH therapy depends on the variety of GH de ficiency, the type of bone studied and the duration of therapy. In the childhood-onset, GH-deficient adult there is either no change or a re duction in cortical and integral bone mass over the first 6 months, wh ereas at 6 months there is an increase in vertebral trabecular BMD. Su bsequently there is a steady rise in BMD at all sites over the next 12 -18 months. In the adult-onset, GH-deficient adult, the long-term resu lts are more contentious. It is too early to determine whether GH ther apy modifies fracture risk.