Bone density after completion of growth hormone treatment for growth failure

Bone density was determined by DEXA scan at completion of growth hormone (GH) therapy in 56 (female/male 9/47) young adults who received GH therapy for growth failure. The z-scores for total and L2-4 bone density were determined from standard curves for age. There was no association of BMD with size. The z-scores for total body and L2-4 bone density indicated a disproportionate number with z-score < -1 SD. Thirty-four percent had z-score < -1 compared to the expected 17% for a normal distribution. The markers of bone metabolism, duration of therapy, initial or final stimulated GH levels, adult height, and percentage body fat did not define those who had decreased bone density. Percentage body fat was inversely associated with stimulated GH levels. We conclude that children who have completed GH therapy may have decreased bone density at completion of therapy and that the GH response to secretagogues does not define this group. The significance of this finding will require additional cross-sectional and longitudinal studies.