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Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency

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Abstract

Cross-sectional studies showed an elevated prevalence of clinical and morphometric vertebral fractures (VFs) in adult patients with growth hormone deficiency (GHD). However, no data are available on incidence and determinants of radiological VFs in this clinical setting. In this prospective study, we investigated the incidence and risk factors of radiological VFs in adults with GHD. Forty patients with GHD (28 males, 12 females; median age 44 years, range 19–82) were studied for incident VFs using quantitative morphometric approach on spine X-ray at baseline and after 6 years of follow-up. GHD patients were also studied for bone mineral density (BMD) measured by DXA at lumbar spine. After 6 years of follow-up, 12 patients (30 %) experienced incident VFs. Patients with incident VFs had more frequently untreated GHD and prevalent VFs at baseline, as compared to patients who did not experience incident VFs. Untreated GHD patients were significantly older as compared to treated GHD (50 years, range 19–82 vs. 36 years, range 19–75; p = 0.003), but the correlation between high risk of VFs and untreated GHD remained significant even after adjustment for the age of patients (odds ratio 6.8, CI 95 % 1.1–41.8; p = 0.037). In GHD patients experiencing incident VFs, lumbar spine BMD decreased significantly whereas it did not change in patients not developing VFs. This is the first prospective study confirming the hypothesis suggested by cross-sectional studies that untreated GHD may cause high risk of VFs in adult patients and that recombinant human GH treatment may effectively decrease such a risk.

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Acknowledgments

This study was partially supported by GIOSEG (Glucocorticoid Induced Osteoporosis Skeletal Endocrinology Group), CROMO (Center for Research in Osteoporosis and Bone Metabolism), University of Brescia Italy and MIUR (Italian Ministry for University and Research).

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Authors and Affiliations

  1. Endocrinology, University of Brescia, Via Biseo, 17, 25123, Brescia, Italy

    Gherardo Mazziotti, Mauro Doga, Stefano Frara, Filippo Maffezzoni, Teresa Porcelli, Luigi Cerri & Andrea Giustina

  2. Radiology, University of Brescia, Brescia, Italy

    Roberto Maroldi

  3. Endocrine Unit, Azienda Ospedaliera Carlo Poma, Mantua, Italy

    Gherardo Mazziotti

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  1. Gherardo Mazziotti
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  2. Mauro Doga
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Correspondence to Andrea Giustina.

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GM has received lecture fees from Ipsen. A.G. is a consultant for Ipsen and Pfizer.

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Mazziotti, G., Doga, M., Frara, S. et al. Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency. Endocrine 52, 103–110 (2016). https://doi.org/10.1007/s12020-015-0738-z

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