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BONE MINERAL DENSITY IN GROWTH HORMONE-DEFICIENT CHILDREN. EFFECTS OF LONG-TERM GH THERAPY

Bone mineral density, gr/cm2, (BMD) of the lumbar spine, L2-L4, was measured by dual energy X-ray absorptiometry (Lunar DPX) in 10 prepubertal GH-deficient children (8 boys and 2 girls, chronological age 7 to 12 years) and compared with that of 471 normal controls (256 boys, 215 girls, age range: 1-20 years). GH deficiency was established on the basis of: height < 3rd percentile, growth velocity < 5 cm/y, GH response < 10 ng/ml in two provocative tests, and bone age delayed of two or more years.Before the start of GH therapy, BMD (mean +/− SD) was significantly reduced in GH-deficient children compared with normal age-matched controls (−1.64 +/− 1.08 n=10, p<0.001).During GH therapy (0.6 - 0.7 IU Kg/BW/week, 14.3 +/−2.45 months) all remained prepubertal, and a significant increase, in growth velocity (8.08 +/− 1.56 cm/y, n= 10, p< 0.001), and in BMD (− 1.02 +/− 1.09, n= 10, p < 0.001) was observed in these patients.In conclusion, BMD is reduced in GH-deficient children, and increases after long-term GH therapy. Our results underline the importance of GH in the maintenance of BMD in prepubertal children.