Effects of Recombinant Human Growth Hormone Therapy on Bone Mineral Density in Adults With Growth Hormone Deficiency: A Meta-Analysis
Abstract
Objective GH deficiency is associated with decreased bone mineral density (BMD) and increased fracture risk. Because the effects of recombinant human GH (rhGH) therapy on BMD and bone mineral content have not been systematically investigated, we conducted a meta-analysis of pertinent studies. Design A thorough search of the literature (MEDLINE, EMBASE, and the Cochrane Register) was performed. Relevant studies were divided and analyzed according to their design (randomized/controlled or prospective/retrospective) and duration of rhGH therapy (≤12 months and > 12 months). Results Administration of rhGH led to a significant increase in lumbar spine (LS) and femoral neck (FN) BMD in randomized/controlled studies of more than 1 year [weighted mean difference (95% confidence interval)] of 0.038 g/cm(2) (0.011-0.065) and 0.021 g/cm(2) (0.006-0.037) at the LS and FN, respectively, and a nonsignificant drop at the same sites in studies of shorter duration. In prospective studies, a significant increase in the LS and FN BMD was obtained. On meta-regression, a negative association was observed between the change in LS and FN BMD and subjects' age and a positive association between the BMD change and treatment duration. In a subgroup analysis, the increase in LS and FN BMD was significant in men [0.048 g/cm(2) (0.033-0.064) and 0.051 g/cm(2) (0.003-0.098), respectively] but not in women. Conclusion This meta-analysis suggests a beneficial effect of rhGH replacement on BMD in adults with…
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Similar outcomes (significant increase in BMD) were observed in prospective studies of rhGH administration.
“Similar outcomes were observed in prospective studies.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
During rhGH treatment, BMD decreases within the first months and then increases after at least one year of therapy.
“BMD within the first months of treatment decreased which was followed by a subsequent increase after at least one year of therapy.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
GH replacement promotes bone turnover by stimulating both bone formation and bone resorption, which is prominent during the first phase of GH treatment.
“GH replacement promotes bone turnover by stimulating both bone formation and bone resorption, which is prominent during the first phase of GH treatment.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
The doses of rhGH used in studies varied from 0.2 to 0.96 mg/daily, with higher doses prescribed to women and patients with CO GHD.
“The doses used in studies varied from 0.2 to 0.96 mg/daily with higher doses prescribed to women and patients with CO GHD [57].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
Administration of recombinant human growth hormone (rhGH) resulted in a significant increase in BMD in randomized/controlled studies of more than 12 months.
“Recent meta-analysis revealed that administration of recombinant human growth hormone (rhGH) resulted in a significant increase in BMD in randomized/controlled studies of more than 12 months.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
The beneficial effect of rhGH replacement therapy on BMD is affected by gender, age, and treatment duration.
“This beneficial effect of rhGH replacement therapy is affected by gender, age, and treatment duration.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
After the first phase of GH treatment, bone turnover slows down and bone mass increases.
“After this period bone turnover slows down and bone mass increases [48, 57, 58].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [57]
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Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review
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Yuen, K. C. J., Biller, B. M. K., Radovick, S., Carmichael, J. D., Jasim, S., Pantalone, K. M., & Hoffman, A. R. (2019) · Endocrine Practice · doi:10.4158/gl-2019-0405 · Cited by 298 · see citing works
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Growth hormone deficiency in treated acromegaly
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Pituitary Disorders and Osteoporosis
Bolanowski, M., Halupczok, J., & Jawiarczyk-Przybyłowska, A. (2015) · International Journal of Endocrinology · doi:10.1155/2015/206853 · Cited by 27 · see citing works
- Authors
- Barake, M., Klibanski, A., & Tritos, N. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Tritos, Nicholas A.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-03-01
- Volume
- 99
- Issue
- 3
- Pages
- 852-860
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2052576311
- Cited by
- 102
- References
- 4
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 9 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 11 · 2019: 6 · 2018: 17 · 2017: 10 · 2016: 4 · 2015: 3 · 2014: 7
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- 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
- recombinant human growth hormone, growth hormone deficiency, bone mineral density, bone mineral content, lumbar spine, femoral neck, treatment duration, sex differences, age effects, fracture risk, adults
- MeSH terms
- Adult, Aged, Female, Humans, Hypopituitarism, Male, Middle Aged, Recombinant Proteins, Bone Density, Human Growth Hormone, Young Adult
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