Skeletal consequences of discontinuation of growth hormone at final height

In light of the well-described adult growth-hormone (GH) deficiency syndrome, the traditional clinical practice of discontinuation of GH therapy in GH-deficient adolescent patients at completion of linear growth requires re-evaluation. Peak bone mass, an important determinant of the subsequent risk of osteoporosis-related fracture in later life, occurs several years after the completion of linear growth. Given that GH has important anabolic actions on bone, discontinuation of GH therapy at the completion of linear growth may have adverse consequences for the attainment of peak bone mass in adolescent GH-deficient patients. This paper discusses the role of GH in the attainment of peak bone mass and some of the accumulating evidence that cessation of GH at final height may compromise bone mineral accretion in GH-deficient adolescent patients.