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GH treatment outcomes may be impaired by vitamin D status
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Adults with growth hormone deficiency may need to maintain adequate levels of vitamin D to reach optimal effect of growth hormone therapy on bone quality, according to study findings.
Martin Kužma, MD, PhD, of the department of internal medicine at Comenius University Faculty of Medicine, University Hospital in Slovakia, and colleagues evaluated 57 adults (29 men; mean age, 34.4 years) with GH deficiency who were treated with recombinant human GH (rhGH) for 2 years to determine GH-induced changes in bone mineral density and trabecular bone scores relative to serum 25-hydroxyvitamin D levels.
Researchers evaluated trabecular bone score, lumbar spine BMD, total hip BMD and 25-(OH)D levels at baseline and 24 months. Participants were divided into two groups based on 25-(OH)D levels; the cutoff was the 50th percentile at each follow-up.
During treatment period, the average rhGH dose was 0.26 mg/day at month 0, 0.36 mg/day at month 6, 0.41 mg/day at month 12 and 0.44 mg/day at month 24. Mean serum 25-(OH)D levels were 71.1 nmol/L at baseline, 56.8 nmol/L at month 12 and 51.8 nmol/L at month 24.
Lumbar spine BMD increased by 7.6% and total hip BMD increased by 4.5% throughout the study population after 24 months of GH replacement (P < .05 for both). Men experienced greater increases in lumbar spine BMD (15%) and total hip BMD (9.6%) compared with women (lumbar spine BMD, 5.3%; total hip BMD, 2.8%).
No significant effect on trabecular bone score was found after 24 months of GH therapy in the population as a whole. However, participants with 25-(OH)D above the 50th percentile had an increase in trabecular bone score while those below the 50th percentile showed a decrease (P < .05). A positive link was found between 25-(OH)D and trabecular bone score at month 24 (P < .05).
“This study investigated the effect of 2 years of rhGH replacement in [GD-deficient] adults and assessed the contribution of vitamin D status on response of [trabecular bone score] and BMD,” the researchers wrote. “We observed a positive effect of GH treatment on BMD with no effect of vitamin D status. However, a differential effect of GH on [trabecular bone score] was observed with a [trabecular bone score] increase only in the cohort with 25-(OH)D above the 50th percentile. As such, it is possible that an optimal effect of GH treatment to improve bone quality, represented by [trabecular bone score], in [GD-deficient] adults is achieved only in those with sufficient 25-(OH)D levels.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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