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Growth hormone improves bone mineral content in children with cystic fibrosis
Dana S Hardin1, Chul Ahn, Claude Prestidge
1Department of Pediatrics, University of Texas-Southwestern Medical School, Houston, TX, USA. dana.hardin@utsouthwestern.edu
Insights
Children with cystic fibrosis (CF) have lower bone mineral content (BMC). Growth hormone (GH) treatment significantly improved BMC accrual in these poorly growing children with CF.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism
- Cystic Fibrosis Research
Background:
- Osteoporosis and osteopenia are common in cystic fibrosis (CF), but bone mineral accrual is poorly understood.
- Children with CF often experience poor growth, impacting overall development.
Purpose of the Study:
- To measure bone mineral content (BMC) in non-acutely ill, poorly growing children with CF.
- To assess the relationship between height, lean body mass, and BMC in these children.
- To evaluate the effect of human recombinant growth hormone (GH) on total body BMC.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to measure total-body BMC in 32 prepubertal children with CF.
- Bone mineral content (BMC) and lean tissue mass (LTM) were assessed at baseline, 6 months, and 1 year.
- Children were randomized to receive GH treatment (GHTX) or no treatment (NonTX); hormone levels (sex steroids, IGF-I) were also measured.
Main Results:
- Children with CF showed significantly lower total body BMC and LTM compared to healthy controls, even after matching for height and bone age.
- BMC correlated positively with height, LTM, and IGF-I levels.
- The GH-treated group exhibited a significantly greater increase in height, weight, LTM, and BMC compared to the non-treated group, independent of height changes.
Conclusions:
- Poor bone mineral accumulation is a significant issue in children with CF.
- Growth hormone (GH) treatment effectively enhances bone mineral accrual in children with CF.
- This study provides novel insights into bone health management in pediatric CF patients.
Aim:
Osteoporosis and osteopenia have been reported as common complications of cystic fibrosis (CF); however, little is known about accrual of bone mineral in CF. The goal of our study was to measure bone mineral content (BMC) in non-acutely-ill, but poorly growing children with CF, and to determine the relationship between height, lean body mass and BMC. Our second aim was to evaluate the effect of one year of treatment with human recombinant growth hormone (GH) on total body BMC.
Methods:
We measured total-body BMC using dual energy X-ray absorptiometry in 32 poorly growing (height < or =10th percentile for age) prepubertal Caucasian children (ages 7 years 6 months-12 years 9 months, 17 M and 15, F) with CF. BMC and lean tissue mass (LTM) were measured at baseline, at 6 months and one year. One half of the children were randomly assigned to receive treatment with GH (GHTX). Results were compared to reference data maintained for healthy children matched for age and ethnicity. Sex steroid and IGF-I levels were also measured.
Results:
Children with CF exhibited lower total body BMC and LTM than age-, ethnicity- and gender-matched controls. This was still apparent when the data were matched for height and bone age. BMC correlated with height, LTM, and IGF-I levels. Although at baseline the groups were similar, the GHTX group demonstrated significantly greater increase in height, weight, LTM and BMC than the NonTX group. These differences remained despite correction for increase in height
Conclusion:
Our study is the first to evaluate BMC in children with CF and suggests that poor accumulation of bone mineral is a problem. We have further demonstrated that GH treatment improves accumulation of bone mineral.
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