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Fracture incidence in GH-deficient patients on complete hormone replacement including GH

Holmer, Helene LU ; Svensson, Johan; Rylander, Lars LU ; Johannsson, Gudmundur; Rosen, Thord; Bengtsson, Bengt-Ake; Thoren, Marja; Hoybye, Charlotte; Degerblad, Marie and Bramnert, Margareta LU , et al. (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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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
AMBMR
external identifiers
  • wos:000251292400004
  • scopus:38749152098
ISSN
1523-4681
DOI
10.1359/jbmr.070811
language
English
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yes
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a21f3395-4243-4425-bc27-0d32d269c1e7 (old id 968854)
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2008-01-29 13:56:30
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2017-05-21 03:44:54
@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 Ekström, Eva},
  issn         = {1523-4681},
  keyword      = {growth hormone therapy,hormone deficiency,growth,pituitary deficiency,population study,fracture incidence},
  language     = {eng},
  number       = {12},
  pages        = {1842--1850},
  publisher    = {AMBMR},
  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},
  volume       = {22},
  year         = {2007},
}