Related Experiment Videos
Recombinant human growth hormone replacement therapy and bone metabolism in children
G Zamboni1, F Antoniazzi, L Tatò
1Pediatric Endocrine Unit, University of Verona, Italy.
Insights
Daily recombinant human growth hormone (rhGH) therapy significantly improved bone mineral content and density in children with growth hormone deficiency (GHD). This regimen, compared to thrice-weekly, better optimizes hormone utilization for enhanced bone health.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism
- Hormone Therapy
Background:
- Growth hormone (GH) is crucial for skeletal development, bone turnover, and mineral deposition.
- Children with idiopathic GH deficiency (GHD) often exhibit impaired bone health.
Purpose of the Study:
- To evaluate the impact of two different recombinant human GH (rhGH) therapy regimens on bone mineral status in children with GHD.
- To compare the efficacy of thrice-weekly versus daily rhGH administration.
Main Methods:
- 22 children with GHD (age 5-8 yrs) were divided into two groups: Group 1 (n=10) received 0.5 IU/kg/week rhGH thrice weekly, and Group 2 (n=12) received the same dose daily.
- Bone mineral content (BMC) and BMC/bone width ratio were assessed using dual image-assisted photon absorptiometry.
- Insulin-like growth factor 1 (IGF-1) and osteocalcin (OC) levels were measured.
Main Results:
- Both rhGH regimens increased IGF-1 and osteocalcin levels, with significantly higher levels observed in Group 2 (daily administration).
- Basal BMC and BMC/bone width ratio were lower in GHD patients compared to controls.
- After 6 months, BMC and BMC/bone width ratio significantly increased only in Group 2 patients.
Conclusions:
- Daily rhGH administration is more effective than thrice-weekly administration in improving bone mineral content and density in children with GHD.
- Continuous rhGH supply optimizes hormone utilization, leading to better bone accretion.
- Daily rhGH therapy promotes significant improvements in bone health parameters in pediatric GHD.
Abstract:
Growth hormone (GH) influences not only skeletal growth and maturation but also bone turnover and mineral deposition. The effect on bone mineral status of 2 different regimens of rhGH therapy was evaluated in 22 children with idiopathic GH deficiency (GHD) - age 5-8 yrs; bone age 3-5 yrs. Ten of them (group 1) were treated 3 times a week with rhGH, administered subcutaneously, for a total weekly dose of 0.5 IU/kg and 12 (group 2) with the same weekly dose 6 times per week. Insulin-like growth factor 1 (IGF-1) and osteocalcin (OC) levels increased in both groups after therapy but they were higher in group 2. In basal conditions bone mineral content (BMC) and BMC/bone width ratio (determined by dual image-assisted photon absorptiometry) were significantly lower in patients than in controls and significantly increased after 6 months of rhGH therapy only in patients of group 2. rhGH administered 3 times a week increased IGF-1 and OC levels, indicating that turnover and remodeling processes of the bone had started, but the same dose had to be given every day to lead to calcium deposition in the bones. Probably a continuous supply of rhGH better optimizes the body utilization of the hormone, as indicated by better height velocity and bone density in patients of group 2. The response to an acute load of 1,25(OH)2D3 (1.5 micrograms/day for 4 days), both before and after a month of rhGH therapy (weekly dose of 0.5 IU/kg 6 times were week), was evaluated in 16 children with GHD - age 6-9 yrs.(ABSTRACT TRUNCATED AT 250 WORDS)