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Bone Mineral, Histomorphometry, and Body Composition in Adults with Growth Hormone Receptor Deficiency
Author(s) -
Bachrach Laura K.,
Marcus Robert,
Ott Susan M.,
Rosenbloom Arlan L.,
Vasconez Oswaldo,
Martinez Victor,
Martinez Ana Lucia,
Rosenfeld Ron G.,
GuevaraAguirre Jaime
Publication year - 1998
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.1998.13.3.415
Subject(s) - endocrinology , bone mineral , medicine , osteopenia , femoral neck , bone remodeling , lean body mass , pyridinoline , bone density , n terminal telopeptide , dual energy x ray absorptiometry , osteoporosis , chemistry , body weight , osteocalcin , biochemistry , alkaline phosphatase , enzyme
Growth hormone (GH) and insulin‐like growth factor I (IGF‐I) deficiencies have been associated with osteopenia in both children and adults. To examine the effects of growth hormone resistance on bone mineral and body composition, we studied 11 adults (mean age 30 years) with growth hormone receptor deficiency (GHRD, Laron syndrome) and 11 age‐ and gender‐matched controls from Southern Ecuador. Bone mineral and body composition were determined by dual‐energy X‐ray absorptiometry. Bone physiology was assessed with biochemical markers of bone turnover and dynamic bone histomorphometry. Bone size and body composition differed markedly between subjects with GHRD and controls. Affected adults were 40 cm shorter than controls, had significantly less lean body mass, and had increased percent body fat. Bone mineral content and density (BMD) at the spine, femoral neck, and whole body were significantly lower in adults with GHRD than in controls. Mean BMD Z scores were −1.5 to −1.6 at all sites in affected women and −2.2 to −2.3 in men with GHRD. Estimated volumetric bone density (BMAD) at the spine and femoral neck, however, was not reduced in GHRD. Spine BMAD was 0.210 ± 0.025 versus 0.177 ± 0.021 for affected women versus controls ( p < 0.05) and 0.173 ± 0.018 versus 0.191 ± 0.025 for men with GHRD versus normals ( p = 0.31). Urinary pyridinoline concentrations were significantly greater in adults with GHRD than in controls, while type I collagen C‐telopeptide breakdown products and markers of bone formation did not differ. Differences in histomorphometry were limited to a reduction in trabecular connectivity; bone volume and formation rate were similar to controls. These data confirm the importance of the GH/IGF axis in regulating bone size and body composition. The contribution of these peptides to the acquisition and maintenance of bone mineral is less certain since volumetric bone density was preserved despite low levels of IGF‐I and IGFBP‐3 associated with GH resistance.