Fracture incidence in GH-deficient patients on complete hormone replacement including GH
(2007) In Journal of Bone and Mineral Research 22(12). p.1842-1850- Abstract
- Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential Confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information.... (More)
- Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential Confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively. Results: A more than doubled risk (IRR, 2.29; 95 % CI 1.23-4.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR, 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54; 95% C1, 0.34-0.86) was recorded in AO GHD men. Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH-IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men. (Less)
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https://lup.lub.lu.se/record/968854
- author
- organization
- publishing date
- 2007
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- growth hormone therapy, hormone deficiency, growth, pituitary deficiency, population study, fracture incidence
- in
- Journal of Bone and Mineral Research
- volume
- 22
- issue
- 12
- pages
- 1842 - 1850
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000251292400004
- scopus:38749152098
- ISSN
- 1523-4681
- DOI
- 10.1359/jbmr.070811
- language
- English
- LU publication?
- yes
- id
- a21f3395-4243-4425-bc27-0d32d269c1e7 (old id 968854)
- date added to LUP
- 2016-04-01 12:29:25
- date last changed
- 2022-04-05 23:00:29
@article{a21f3395-4243-4425-bc27-0d32d269c1e7, abstract = {{Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential Confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively. Results: A more than doubled risk (IRR, 2.29; 95 % CI 1.23-4.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR, 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54; 95% C1, 0.34-0.86) was recorded in AO GHD men. Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH-IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men.}}, author = {{Holmer, Helene and Svensson, Johan and Rylander, Lars and Johannsson, Gudmundur and Rosen, Thord and Bengtsson, Bengt-Ake and Thoren, Marja and Hoybye, Charlotte and Degerblad, Marie and Bramnert, Margareta and Haegg, Erik and Engstroem, Britt Eden and Ekman, Bertil and Thorngren, Karl-Goeran and Hagmar, Lars and Erfurth, Eva-Marie}}, issn = {{1523-4681}}, keywords = {{growth hormone therapy; hormone deficiency; growth; pituitary deficiency; population study; fracture incidence}}, language = {{eng}}, number = {{12}}, pages = {{1842--1850}}, publisher = {{Wiley-Blackwell}}, series = {{Journal of Bone and Mineral Research}}, title = {{Fracture incidence in GH-deficient patients on complete hormone replacement including GH}}, url = {{http://dx.doi.org/10.1359/jbmr.070811}}, doi = {{10.1359/jbmr.070811}}, volume = {{22}}, year = {{2007}}, }