Unreplaced Sex Steroid Deficiency, Corticotropin Deficiency, and Lower IGF-I Are Associated with Lower Bone Mineral Density in Adults with Growth Hormone Deficiency: A KIMS Database Analysis
Open accessAbstract
Context: GH deficiency (GHD) is associated with low bone mineral density (BMD). Risk factors for lower BMD in this GHD population have not been fully elucidated. In particular, there are limited published data in GH-naïve subjects. Objective: The objective of the study was to identify endocrine correlates of low BMD in treatment-naïve adult GHD subjects. Design: This was a retrospective analysis of data extracted from the (Pfizer International Metabolic Study) KIMS database. Setting: The study was an international epidemiological survey of more than 15,000 adult GHD patients from 31 countries. Patients: A total of 1218 subjects with stringently defined GHD of adult onset (641 women and 577 men) who were GH naïve and had BMD measured in the posterior anterior lumbar spine and femoral neck by dual-energy X-ray absorptiometry. Main Outcome Measures: Variables associated with standardized BMD (sBMD) in adult-onset GHD were examined. Results: In the LS, body mass index (r = 0.13, P < 0.01), unreplaced sex steroid deficiency (r = −0.17, P < 0.0001), and corticotropin deficiency (r = −0.11, P < 0.01) were independently associated with sBMD. In the FN, age (r = −0.19, P < 0.0001), female gender (r = −0.18, P < 0.0001), body mass index (r = 0.21, P < 0.0001), and decreased IGF-I sd scores (r = 0.10, P < 0.001) were independently associated with sBMD. Conclusions: Hormone variables associated with lower sBMD in patients with adult-onset GHD include unreplaced sex steroid deficiency and corticotropin deficiency in the LS and lower IGF-I SDS in the FN.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with isolated GH deficiency and with multiple pituitary deficiencies usually have low BMD.
“Patients with isolated GH deficiency (GHD) and with multiple pituitary deficiencies usually have low BMD.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
The Abstract (page unavailable) says GHD is associated with low BMD, and the Discussion (page unavailable) identifies additional pituitary hormone deficiencies as possible predictors of lower BMD. The passages do not establish that patients in both the isolated-GHD and multiple-deficiency groups usually have low BMD; in particular, they provide no prevalence for either group. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn patients with childhood onset GHD, there is a clear reduction in BMD.
“In patients with childhood onset (CO) GHD there seems to be a clear reduction in BMD, which may present the potential role of GH in the achievement of peak bone mass [44–49].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
The paper states that GHD is associated with low BMD (opening background passage, labeled Abstract in our copy). But its study population comprised adults with adult-onset GHD (Abstract; Results), so it does not establish a clear BMD reduction specifically in patients with childhood-onset GHD. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGH may play a role in the achievement of peak bone mass.
“which may present the potential role of GH in the achievement of peak bone mass [44–49].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
The introductory passage says GH affects bone directly and through IGF-I, and the Discussion describes an important role for GH in bone strength (page numbers unavailable). But the study examines bone density in adults with adult-onset GH deficiency; it does not address GH’s role in achieving peak bone mass. (LLM, conf=0.82)
Experimental — accuracy not yet measuredBMD in patients with hypopituitarism and untreated GHD might be affected by age at onset, gender, body mass index, gonadal status, and severity of GHD.
“According to the literature BMD might be affected by many factors such as age at onset, gender, body mass index, gonadal status, and the severity of growth hormone deficiency [47, 49, 51].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
Pituitary hormone deficiencies causing hypogonadism, hypothyroidism, or hypoadrenalism may contribute to bone loss.
“Pituitary hormone deficiencies causing hypogonadism, hypothyroidism, or hypoadrenalism may also contribute to bone loss.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
The association between ACTH or TSH deficiency and lower BMD might be a consequence of either deficiencies of pituitary hormones or excessive hormone replacement.
“might be a consequence of either deficiencies of pituitary hormones or excessive hormone replacement [47, 53, 54].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
The mechanisms underlying the association between ACTH or TSH deficiency and lower BMD are not clarified.
“The mechanisms underlying the association between either ACTH or TSH deficiency and lower BMD are not clarified”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [47]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 30 · Cited by 40
- Authors
- Tritos, N. A., Greenspan, S. L., King, D., Hamrahian, A., Cook, D. M., Jönsson, P. J., Wajnrajch, M. P., Koltowska-Häggstrom, M., & Biller, B. M. K.
- Affiliations
- Harvard University (US)
- University of Pittsburgh (US)
- Pfizer (United States) (US)
- Cleveland Clinic (US)
- Oregon Health & Science University (US)
- Pfizer (Sweden) (SE)
- KIMS Medical Outcomes (P.J.J., M.K.-H.), Pfizer Endocrine Care, 191 90 Sollentuna, Sweden;
- Corresponding author
- Tritos, Nicholas A.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-05-01
- Volume
- 96
- Issue
- 5
- Pages
- 1516-1523
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC5393425
- OpenAlex
- W2088975071
- Cited by
- 40
- References
- 30
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 3 · 2018: 5 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 2 · 2012: 4
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen
- Eli Lilly and Company
- Pfizer
- Massachusetts General Hospital
- Novo Nordisk
- National Institute on Aging (P30AG024827)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- adult-onset growth hormone deficiency, bone mineral density, sex hormone deficiency, corticotropin deficiency, insulin-like growth factor I, body mass index, femoral neck, lumbar spine
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Arginine, Female, Glucose Tolerance Test, Humans, Insulin-Like Growth Factor I, Male, Middle Aged, Pituitary Diseases, Retrospective Studies, Sex Characteristics, Gonadal Steroid Hormones, Growth Hormone, Spine, Stimulation, Chemical, Absorptiometry, Photon, Bone Density, Body Mass Index, Databases, Factual, Age of Onset, Human Growth Hormone, Hormone Replacement Therapy, Fractures, Bone, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
