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The effect of growth hormone deficiency on size-corrected bone mineral measures in pre-pubertal children

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Abstract

Summary

Growth hormone deficiency (GHD) in children has been frequently perceived to be a cause of low bone mass accrual. The confounding effects of poor growth limit the interpretation of prior studies of bone health in GHD. We studied size-corrected bone mineral measures in 30 pre-pubertal GHD children and 75 healthy controls. Our study shows that size-corrected whole-body bone mineral content of GHD children were comparable with controls.

Introduction

The purpose of this study is to evaluate the effects of GHD on size-corrected bone measures at the lumbar spine (LS) and the whole body (WB).

Methods

LS bone area (BA), LS bone mineral content (BMC), WB BA, WB BMC, and lean body mass (LBM) were measured in 30 pre-pubertal GHD children and 75 controls by dual-energy X-ray absorptiometry. Multiple linear regressions were used to calculate size-corrected (Sc) LS BASc, LS BMCSc, WB BASc, and WB BMCSc from control subjects using height and age as independent variables. Furthermore, the relationship between muscle and bone was studied by first assessing LBM for height (LBMHt) and then determining WB BMC for LBM (WB BMCLBM). All values were converted to Z-scores and compared with the control.

Results

At diagnosis, WB BMCSc Z-score of GHD children was not significantly different from controls. However, mean Z-scores of LS BASc (−0.89 ± 0.84, p < 0.0001), LS BMCSc (−0.70 ± 1.1, p < 0.001), WB BASc (−0.65 ± 1.0, p < 0.006), and LBMHt (−0.66 ± 1.7, p < 0.01) were significantly reduced, and WB BMCLbm (0.78 ± 1.5, p < 0.003) was significantly higher in GHD children than controls.

Conclusion

Size-corrected WB BMC of GHD children were comparable with controls, and bones were normally adapted for muscle mass. Determinants of bone strength which may primarily be affected by GHD are muscle mass, bone size, and geometry rather than bone mass.

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Acknowledgement

We acknowledge the help of Professor Vijaylaxmi Bhatia, Dept of Endocrinology & Metabolism, Sanjay Gandhi Postgraduate Institute, Lucknow and Professor Nalini Shah, Dept of Endocrinology & Metabolism, KEM hospital Mumbai, for critical review of the manuscript.

Conflicts of interest

None.

Funding

The project described was supported by grant number 1 D43 HD065249 from the Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health & Human Development at the National Institutes of Health.

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Authors and Affiliations

  1. Department of Dietetics and Nutrition, All India Institute of Medical Sciences, New Delhi, India

    M. Gahlot

  2. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India

    R. Khadgawat, R. Ramot, M. Eunice, A. C. Ammini & N. Gupta

  3. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    M. Kalaivani

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  1. M. Gahlot
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Correspondence to R. Khadgawat.

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Gahlot, M., Khadgawat, R., Ramot, R. et al. The effect of growth hormone deficiency on size-corrected bone mineral measures in pre-pubertal children. Osteoporos Int 23, 2211–2217 (2012). https://doi.org/10.1007/s00198-011-1825-5

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  • DOI: https://doi.org/10.1007/s00198-011-1825-5

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