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Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy

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Abstract

Purpose

The effects of growth hormone (GH) replacement on bone mass and body composition in adult with GH deficiency (AGHD) are still debated with regard to their persistence in the long term. Moreover, the impact of the gender on the response to GH is controversial. Aim of this study was to evaluate the long-term effects of rhGH replacement on bone mass and body composition in a monocentric cohort of patients with AGHD.

Methods

Data from 118 patients with AGHD (34.8 ± 14.4 years, 43 women and 75 men) treated with rhGH for a period of at least 3 years up to a maximum of 10 were retrospectively collected. Bone mineral density (BMD) at the lumbar spine, femur, and 1/3 radius, and total and truncular body composition were evaluated by dual-energy X-ray absorption (DXA) before and during treatment. Clinical and laboratory evaluations were performed before and during the treatment period on an annual basis.

Results

Lumbar spine BMD consistently increased in males, while it decreased in females after a transient improvement observed during the first 4 years of therapy. There were no significant changes in femoral and 1/3 radial BMD in either sexes. Lean mass significantly increased in both sexes, while fat mass only decreased in males.

Conclusions

In AGHD patients long-term rhGH replacement therapy induces a positive effect with regard to bone mass and body composition. A sexual dimorphism in the response to treatment is evident, with males displaying a more favorable outcome.

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Data availability

Data are available on request from the corresponding author.

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Acknowledgements

We gratefully acknowledge the skillful assistance of Prof. Maristella Sena in the formal revision of the manuscript.

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Authors and Affiliations

  1. Endocrinology and Diabetes Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, Bergamo, 24127, Italy

    Alessandro Rossini

  2. Endocrinology Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Roberto Lanzi & Francesca Perticone

  3. Bicocca Applied Statistics Center (B-ASC), Università degli Studi di Milano-Bicocca, Milano, Lombardia, Italy

    Carlotta Galeone

  4. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Claudio Pelucchi

  5. AnacletoLab, Department of Computer Science, University of Milan, Milan, Italy

    Mario Pennacchioni

  6. Bone Metabolic Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Marcella Sirtori & Alessandro Rubinacci

  7. Neurosurgery Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Marco Losa

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  1. Alessandro Rossini
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  2. Roberto Lanzi
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  9. Alessandro Rubinacci
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by R.L., F.P., M.S., and M.L. Statistical analysis was performed by C.G., C.P., and M.P. The first draft of the manuscript was written by A.R. and A.R., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alessandro Rossini.

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The authors declare no competing interests.

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patients gave standard written informed consent to the use of their anonymized clinical data for research purposes.

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This is an observational study. The San Raffaele Scientific Institute Research Ethics Committee has confirmed that no ethical approval is required.

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Rossini, A., Lanzi, R., Galeone, C. et al. Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy. Endocrine 74, 666–675 (2021). https://doi.org/10.1007/s12020-021-02835-6

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