Changes in bone mineral density after discontinuation and early reinstitution of growth hormone (GH) in patients with childhood-onset GH deficiency

We measured bone mass density (BMD) in 28 childhood-onset adult GHD patient s (20 MPHD, 8 IGHD) treated with hGH until final height. Twelve were re-tre ated with hGH (0.06 U/kg/day three times per week) for 16-24 months and eig ht of them followed for up to 5 years. Age at start of the study was 23.6 /- 5.7 years (mean +/- SD) and the interval since the first hGH treatment w as 5.8 +/- 4.4 years Baseline BMD was 82% of young normal healthy subjects. Patients < 20 years had a lower BMD than those > 20 years (75 vs 87%; P = 0.004). in the 12 patients re-treated with GH, BMD was 5.3% above baseline at 6 months after treatment was stopped (P < 0.002), and remained so for 3. 5 years in eight patients who completed follow-up. In conclusion, increases in BMD occur after cessation of growth, but continuation of hGH treatment after final height achievement may prevent the late osteopenia of patients with childhood-onset GHD. (C) 1999 Harcourt Publishers Ltd.