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Bone mineral density in adults growth hormone deficiency with different ages of onset: a real-world retrospective study

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Abstract

Purpose

Bone mineral density (BMD) impairment is one of the critical factors for long-term quality of life in adults growth hormone deficiency (AGHD). This study aims to investigate the annual changes in BMD in AGHD patients with different ages of onset and to identify predicting factors that influence BMD.

Methods

AGHD patients (n = 160) with available data for 4 years follow-up from a major tertiary medical center in China were retrospectively included (110 [68.8%] childhood-onset, 119 [74.4%] male). BMD of the axial bone (including total hip, neck of femur, and L1–4) derived from dual X-ray absorptiometry and final height were investigated at the first visit, 12 months, 24 months, 36 months, and 48 months thereafter. Low BMD was defined as Z-score ≤ −2.

Results

The prevalence of low BMD was 30.0% at baseline and 12.5% at 4 years of follow-up. The CO AGHD group presented a significantly lower BMD than the AO AGHD group at the baseline (P = 0.009). In contrast, the CO AGHD group had significantly greater median annual BMD change than the AO AGHD group (0.044 vs. −0.0003 g/cm2/year in L1–4, P < 0.001), indicating a significant difference in the overall BMD trend between CO and AO groups. Childhood-onset (odds ratio [OR] 0.326, P = 0.012), low serum testosterone (OR 0.847; P = 0.004) and FT4 (OR 0.595; P = 0.039) level were independent risk factors for BMD loss.

Conclusion

The annual changes of BMD show a different pattern in AGHD patients with varying ages of onset. Patients with CO AGHD have a lower bone mass, and in general, appropriate replacement therapy is necessary for long-term bone health in AGHD patients.

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Data availability

All data supporting the conclusions of this manuscript are included in this published article or available from the corresponding author upon request.

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Acknowledgements

The authors thank the technical support of the PUMCH-EMERALD platform.

Funding

This work was supported by the National Natural Science Foundation of China (No. 81970678); National High Level Hospital Clinical Research Funding (2022-PUMCH-B-016); and CAMS Innovation Fund for Medical Sciences (CIFMS 2021-I2M-1-003).

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Author notes

  1. These authors contributed equally: Hongbo Yang, Meiping Chen

Authors and Affiliations

  1. Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China

    Hongbo Yang, Meiping Chen, Hanyuan Xu, Linjie Wang, Lian Duan, Fengying Gong, Huijuan Zhu & Hui Pan

  2. Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China

    Hanyuan Xu

  3. Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China

    Yunfeng Zhen

  4. Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China

    Yuelun Zhang

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Contributions

All authors contributed to the study’s conception and design. Hongbo Yang and Meiping Chen wrote the draft of the manuscript and prepared figures and tables; Huijuan Zhu and Hui Pan designed the study; Linjie Wang, Lian Duan, Yunfeng Zhen, and Hanyuan Xu collected the clinical data; Fengying Gong helped analyze biochemical data; Yuelun Zhang guided the data processing and statistical analysis. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Huijuan Zhu or Hui Pan.

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Yang, H., Chen, M., Xu, H. et al. Bone mineral density in adults growth hormone deficiency with different ages of onset: a real-world retrospective study. Endocrine (2024). https://doi.org/10.1007/s12020-024-03786-4

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