2 YEARS OF GROWTH-HORMONE (GH) TREATMENT INCREASES BONE-MINERAL CONTENT AND DENSITY IN HYPOPITUITARY PATIENTS WITH ADULT-ONSET GH DEFICIENCY

The main purpose of this trial was to determine the effects of 2 yr of GH treatment on bone mineral density (BMD) and bone metabolism in pat ients with adult-onset GH deficiency. Forty-four patients (24 men and 20 women; aged 23-66 yr) participated in a 2-yr open treatment trial w ith recombinant human GH. BMD was assessed with dual energy x-ray abso rptiometry, and serum concentrations of osteocalcin, carboxy-terminal propeptide of type I procollagen (PICP), and carboxy-terminal cross-li nked telopeptide of type I collagen (ICTP) were measured. After 2 yr o f GH treatment, the BMD increased in the lumbar spine L2-L4 by 3.8% [9 5% confidence interval (CI), 2.1-5.5], in the femoral neck by 4.1% (CI , 2.1-6.1), in the femoral trochanter by 5.6% (CI, 3.8-7.4), and in Wa rd's triangle by 4.9% (CI, 2.2-7.6) compared with baseline. Patients w ith a z-score (difference in so from the mean of age- and sex-matched subjects) below -1 SD responded with the most marked BMD increment. Th e serum concentrations of osteocalcin, PICP, and ICTP remained higher throughout the 2 yr of treatment. Women demonstrated a more marked inc rease in total body BMD and a less pronounced initial increment in ost eocalcin, PICP, and ICTP than men. Two years of GH treatment induced a sustained increase in overall bone remodeling activity, which resulte d in a net gain in BMD that was more marked in those subjects with a l ow pretreatment z-score.