ESPE Abstracts (2019) 92 FC6.5

No Change in Bone Density During 6 Months Off GH in Adolescents with Severe GHD at Near-Adult Height

Roland Schweizer1, Julia Donner2, Bettina Becker1, Jana Leonie Bauer1, Gerhard Binder1


1University Children's Hospital, Pediatric Endocrinology, Tübingen, Germany. 2The Warren Alpert Medical School of Brown University, Providence, USA


Objective: Re-testing of childhood-onset GHD needs discontinuation of GH treatment at near-adult height. We recently reported significant changes of body composition as a consequence of severe GHD during this time period.

Aim: Does a 6 month interruption of GH treatment decrease bone quality significantly in patients with severe GHD of adolescence?

Patients and Methods: In 90 patients with childhood onset GHD treatment was stopped when patients reached near-adult height (HV <2cm/yr). After three months patients were retested with arginine-GHRH-test. After six months GH treatment was restarted in patients with a GH maximum <16 ng/ml and low IGF-1 (n=17, 4 females, mean age 16.3 yr). At stop of GH treatment and at 6 months off GH we performed a pQCT scan (XCT 2000 Stratec corp. Germany) of the non-dominant forearm at the 4 and 65% measure points. Measures of patients with severe GHD of adolescence were compared to that of patients with transient GHD of childhood (n=73, 15 females, mean age 17.1 yr,).

Results: In severe GHD of adolescence the trabecular density decreased from 214 to 202mg/cm3 (P<0.01); in transient GHD a similar decrease from 220 to 214 was observed (P<0.05).The trabecular density remained within the reference range in both groups.

In both groups increases were observed with respect to cortical density from 1077 to 1099 mg/cm3 (P<0.01) versus 1060 to 1079 mg/cm3 (P<0.001), with respect to strength strain index from 306 to 310 mm3 (n.s.) vs. 302 to 312 mm3 (P<0.05), and with respect to total bone area from 145 to146 mm2 (n.s.) vs. 153 to 155 mm2 (n.s.). The changes of bone density and geometry were comparable.

Conclusion: Only trabecular density decreased significantly during 6 months off GH in all patients, independent of their GH status. Therefore we conclude that discontinuation of GH treatment for confirmation of the diagnosis does not harm the bone.

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