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

• Published in: Osteoporosis international Vol. 23; no. 8; pp. 2211 - 2217
• Main Authors: Gahlot, M., Khadgawat, R., Ramot, R., Eunice, M., Ammini, A. C., Gupta, N., Kalaivani, M.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-08-2012; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Adrenarche - physiology; Age; Biomarkers - metabolism; Body Composition; Body Height - physiology; Bone density; Bone Density - physiology; Bone growth; Bone mass; Bone mineral content; Bone strength; Case-Control Studies; Child; Child, Preschool; Children; Children & youth; Dual energy X-ray absorptiometry; Endocrinology; Female; Growth hormone; Growth Hormone - deficiency; Growth hormones; Humans; Lean body mass; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - physiology; Male; Medicine; Medicine & Public Health; Minerals; Muscles; Original Article; Orthopedics; Osteoporosis; Rheumatology; Spine (lumbar); Lean body mass; Growth hormone deficiency; Size correction
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-011-1825-5

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 BA
Sc
, LS BMC
Sc
, WB BA
Sc
, and WB BMC
Sc
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 (LBM
Ht
) and then determining WB BMC for LBM (WB BMC
LBM
). All values were converted to Z-scores and compared with the control.
Results
At diagnosis, WB BMC
Sc
Z-score of GHD children was not significantly different from controls. However, mean Z-scores of LS BA
Sc
(−0.89 ± 0.84,
p
 < 0.0001), LS BMC
Sc
(−0.70 ± 1.1,
p
 < 0.001), WB BA
Sc
(−0.65 ± 1.0,
p
 < 0.006), and LBM
Ht
(−0.66 ± 1.7,
p
 < 0.01) were significantly reduced, and WB BMC
Lbm
(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.