EFFECTS OF RECOMBINANT GROWTH-HORMONE (GH) TREATMENT ON BONE-MINERAL DENSITY AND BODY-COMPOSITION IN ADULTS WITH CHILDHOOD-ONSET GROWTH-HORMONE DEFICIENCY

Lumbar spine, whole proximal femur and total body bone mineral density (BMD, g/cm(2)) and the regional soft tissue composition were measured with dual energy X-ray absorptiometry (Hologic QDR 1000/W) in eight a dults with childhood onset GHD, before and after 6 months of recombina nt GH treatment (0.5 IU/kg/week). Data obtained from patients were com pared with those recorded in an age and sex matched control group. Bef ore treatment, lumbar (L2-L4) spine BMD (mean+/-SD: 0.811+/-0.159 g/cm (2)), whole proximal femur BMD (0.739+/-0.094 g/cm(2)) and total body BMD (0.946+/-0.087 g/cm(2)) of patients were significantly (p<0.001, 0 .01 and 0.001, respectively) lower than those recorded in an age- and sex-matched control group (1.077+/-0.155 g/cm(2), 0.968+/-0.166 g/cm(2 ) and 1.168+/-0.058 g/cm(2), respectively), although three patients sh owed BMD values at the lower limit of the normal range. Mean lumbar sp ine BMD, whole proximal femur BMD and total body BMD did not significa ntly change alter 6 months' GH treatment (-1.4+/-3.7%, +2.7+/-3.7% and -1.1+/-5.0% vs basal values, respectively). On the other hand, trocha nteric subregion showed a significant 4.8+/-5.3% increase (vs basal, p <0.05), while other hip subregions did not show significant changes. G H therapy caused marked effects on body composition; in fact, a signif icant decrease (p<0.01) of trunk fat (-25.2+/-15.0%) and a marked incr ease (p<0.01) of limbs lean mass (+10.0+/-5.3%), resulting in a signif icant (p<0.02) reduction (-16.5+/-13.5%) of the axial to peripheral fa t ratio (APFR), were clearly evident after six months of therapy. In c onclusion, our study shows that six months of GH treatment do not exer t relevant effects on the BMD of adults with childhood onset GHD. On t he contrary, the effects of GH therapy on body composition are more ma rked, being clearly appreciable after six months of treatment. (C) 199 6, Editrice Kurtis