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Fracture incidence in GH-deficient patients on complete hormone replacement including GH
Centralsjukhuset, Kristianstad, Sweden.
Sahlgrenska University Hospital, Göteborg, Sweden.
Lund University, Sweden.
Sahlgrenska University Hospital, Göteborg, Sweden.
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2007 (English)In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 22, no 12, 1842-1850 p.Article in journal (Refereed) Published
Abstract [en]

Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men. Introduction: The objective of this study was to evaluate fracture incidence in patients wilh confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential confounders and effect modifiers into account. Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively. Results: A more than doubled risk (IRR, 2.29, 95% CI, 1.23-4.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR. 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54, 95% CI 0.34-0.86) was recorded in AO GHD men. Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH-IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men.

Place, publisher, year, edition, pages
2007. Vol. 22, no 12, 1842-1850 p.
Keyword [en]
population study, fracture incidence, pituitary deficiency, growth hormone deficiency, growth hormone therapy
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-42528DOI: 10.1359/jbmr.070811Local ID: 65300OAI: oai:DiVA.org:liu-42528DiVA: diva2:263385
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13

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Ekman, Bertil

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Internal MedicineFaculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHL
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