Fracture incidence in GH-deficient patients on complete hormone replacement including GH

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Abstract

Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential Confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively. Results: A more than doubled risk (IRR, 2.29; 95 % CI 1.23-4.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR, 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54; 95% C1, 0.34-0.86) was recorded in AO GHD men. Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH-IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men.

Detaljer

Författare
  • Helene Holmer
  • Johan Svensson
  • Lars Rylander
  • Gudmundur Johannsson
  • Thord Rosen
  • Bengt-Ake Bengtsson
  • Marja Thoren
  • Charlotte Hoybye
  • Marie Degerblad
  • Margareta Bramnert
  • Erik Haegg
  • Britt Eden Engstroem
  • Bertil Ekman
  • Karl-Goeran Thorngren
  • Lars Hagmar
  • Eva Ekström
Enheter & grupper
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Endokrinologi och diabetes
  • Miljömedicin och yrkesmedicin
  • Annan klinisk medicin

Nyckelord

Originalspråkengelska
Sidor (från-till)1842-1850
TidskriftJournal of Bone and Mineral Research
Volym22
Utgivningsnummer12
StatusPublished - 2007
PublikationskategoriForskning
Peer review utfördJa