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      Long-Term Effects of Growth Hormone Therapy on Bone Mineral Density, Body Composition, and Serum Lipid Levels in Growth Hormone Deficient Children: A 6-Year Follow-Up Study

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          Abstract

          Aim: To study the effects of growth hormone (GH) deficiency (GHD) and GH replacement therapy (GHRx) on bone mineral density (BMD) and body composition. Methods: 59 GHD children participated (age range 0.4–16.9 years); the follow-up period was 6 years. Lumbar spine BMD (BMD<sub>LS</sub>), total-body BMD (BMD<sub>TB</sub>), and body composition were measured prospectively using dual-energy X-ray absorptiometry. Results: Mean BMD<sub>LS </sub>and BMD<sub>TB</sub> were significantly reduced at the time of the diagnosis. The bone mineral apparent density of the lumbar spine (BMAD<sub>LS</sub>) was reduced to a lesser degree. The BMAD<sub>LS</sub> increased to normal values after 1 year; BMD<sub>LS</sub> and BMD<sub>TB</sub> normalized 1 year later. At the time of the diagnosis, the lean body mass was reduced and steadily increased during GHRx. Percentage of body fat was increased at baseline and normalized within 6 months. The severity of GHD was not associated with the BMD at diagnosis or the response to GHRx. Conclusion: Areal BMD<sub>LS</sub> and BMD<sub>TB</sub> and, to a lesser extent, BMAD<sub>LS</sub> are decreased in GHD children, but normalize within 1–2 years.

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            Premature mortality due to cardiovascular disease in hypopituitarism

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              Comparison of different models for interpreting bone mineral density measurements using DXA and MRI technology.

              Bone mineral density measurements using dual X-ray absorptiometry (DXA) are commonly expressed as areal density (g/cm2). However, areal BMD (BMDareal) is dependent on bone size and this can lead to erroneous interpretations of BMD values. We have previously presented a simple method for calculating apparent volumetric bone mineral density (BMDvol) using ancillary DXA-derived data. In the present study we tested the validity of our model using in vivo volumetric data obtained from magnetic resonance imaging (MRI) of lumbar vertebrae. BMDareal and BMDvol of L3 were measured from sixteen pairs of identical twins (24 men, 8 women), aged 25-69 years. The dimensions of the lumbar vertebra L3 were measured from MR images and BMD values were corrected for these dimensions. The DXA-derived apparent volumetric bone mineral density (BMDvol) correlated moderately with MRI-derived BMDs (r values from 0.665 to 0.822). In contrast to BMDareal, BMDvol and MRI-derived BMDs were not related to body size variables. All these volume-corrected BMDs diminished the erroneous effect of vertebral size on areal BMD. We conclude that the simple DXA-derived BMDvol can be used for normalization of bone mineral density values in subjects of different body sizes, and especially in growing children.
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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                1663-2818
                1663-2826
                2002
                2002
                28 October 2002
                : 58
                : 5
                : 207-214
                Affiliations
                Departments of aPediatrics, Subdivision of Endocrinology, bRadiology, and cClinical Chemistry, Sophia Children’s Hospital, dDepartment of Epidemiology and Biostatistics, Erasmus University, and eDepartment of Nuclear Medicine, Dijkzigt Hospital, Rotterdam, The Netherlands
                Article
                66262 Horm Res 2002;58:207–214
                10.1159/000066262
                12401939
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 3, References: 44, Pages: 8
                Categories
                Original Paper

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