Journal ArticleDOI
Growth hormone replacement in adults and bone mineral density: a systematic review and meta‐analysis
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TLDR
A systematic review of randomized trials that compared GH to no active treatment, with BMD as an outcome, found that the effect of GH replacement on bone mineral density (BMD) in adults with GH deficiency (GHD) is uncertain.Abstract:
Summary
background The effect of GH replacement on bone mineral density (BMD) in adults with GH deficiency (GHD) is uncertain. We carried out a systematic review of randomized trials that compared GH to no active treatment, with BMD as an outcome.
methods We searched electronic databases to identify articles, abstracts and conference proceedings to March 2002. We also checked reference lists in included studies and expert reviews. Two reviewers independently extracted the data on study design and change in BMD. The results of individual trials were combined by fixed effects model meta-analysis using weighted mean difference (WMD) of change in BMD at the lumbar spine (our primary outcome) and other sites.
findings Eighteen trials that included 700 patients met the inclusion criteria. Maximum follow-up was for 12 weeks (1 trial), 6 months (14 trials), 12 months (1 trial), 18 months (1 trial) and 24 months (1 trial). Reporting quality of both study design and results was poor. Ten trials (458 subjects) were included in the meta-analysis. We excluded those eight trials from which sufficient data could not be extracted. We found a mean change in BMD, at the lumbar spine with GH treatment, of 0·01 g/cm2 after 6 and 12 months, 0·02 g/cm2 after 18 months and 0·03 g/cm2 after 24 months. Statistical significance at the 0·05 level was just achieved at 6 and 12 months but was significant at 18 and 24 months. These changes are small and may be influenced by bias.
conclusion There is evidence of a small effect of GH replacement on bone mineral density in adults with GH deficiency. The clinical importance of this is uncertain.read more
Citations
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Journal ArticleDOI
Growth Hormone, Insulin-Like Growth Factors, and the Skeleton
TL;DR: GH and IGF-I secretion are decreased in aging individuals, and abnormalities in the GH/IGF-I axis play a role in the pathogenesis of the osteoporosis of anorexia nervosa and after glucocorticoid exposure.
Journal ArticleDOI
Increased prevalence of radiological spinal deformities in adult patients with GH deficiency: influence of GH replacement therapy.
Gherardo Mazziotti,Antonio Bianchi,Stefania Bonadonna,Monica Nuzzo,Vincenzo Cimino,Alessandra Fusco,Laura De Marinis,Andrea Giustina +7 more
TL;DR: Patients undergoing GH replacement treatment showed a significantly lower prevalence of vertebral deformities versus treated patients in the presence of similar BMD, as assessed by DXA.
Journal ArticleDOI
Guidelines for the treatment of growth hormone excess and growth hormone deficiency in adults.
Andrea Giustina,Ariel L. Barkan,Philippe Chanson,Ashley B. Grossman,Andrew R. Hoffman,Ezio Ghigo,Felipe F. Casanueva,A. Colao,S. W. J. Lamberts,Michael C. Sheppard,Shlomo Melmed +10 more
TL;DR: The V Consensus Group Meeting on ‘Guidelines for Treatment of GH Excess and GH Deficiency in the Adult’ was an international workshop held on February 20–22, 2006 in Santa Monica, California, USA to provide guidelines for the evaluation and treatment of adults with either form of abnormal GH secretion.
Journal ArticleDOI
Childhood growth hormone deficiency, bone density, structures and fractures: scrutinizing the evidence
Wolfgang Högler,Nick Shaw +1 more
TL;DR: There is no evidence that isolated childhood‐onset GHD, or severe GH resistance, causes an increased fracture risk in children or adults, and there is a need to review current transition guidelines.
Journal ArticleDOI
Effects of recombinant human growth hormone therapy on bone mineral density in adults with growth hormone deficiency: a meta-analysis.
TL;DR: A meta-analysis suggests a beneficial effect of rhGH replacement on BMD in adults with GH deficiency, affected by gender, age, and treatment duration.
References
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Journal ArticleDOI
Assessing the quality of reports of randomized clinical trials : is blinding necessary?
Alejandro R. Jadad,R. A. Moore,Dawn Carroll,C. Jenkinson,David Reynolds,David J. Gavaghan,Henry J McQuay +6 more
TL;DR: An instrument to assess the quality of reports of randomized clinical trials (RCTs) in pain research is described and its use to determine the effect of rater blinding on the assessments of quality is described.
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Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures
TL;DR: Measurements of bone mineral density can predict fracture risk but cannot identify individuals who will have a fracture, and a programme of screening menopausal women for osteoporosis by measuring bone density cannot be recommended.
Journal ArticleDOI
Variance imputation for overviews of clinical trials with continuous response
TL;DR: Heuristic suggestions for variance imputation based on partial variance information are provided and a key idea is to use separate sources of incomplete information to help choose a better variance estimate.
Journal ArticleDOI
96153999 Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures
D. Marshall,O. Johnell,H. Wedel +2 more
TL;DR: Measurements of bone mineral density can predict fracture risk but cannot identify individuals who will have a fracture, and a programme of screening menopausal women for osteoporosis by measuring bone density is not recommended.
Journal ArticleDOI
Growth hormone and bone.
Claes Ohlsson,Claes Ohlsson,Bengt-Åke Bengtsson,Olle Isaksson,Troels T. Andreassen,Maria C. Slootweg +5 more
TL;DR: The biphasic model of GH action in bone remodeling is proposed, based on findings in GHD adults, and it appears that the "transition point" occurs after approximately 6 months and that a net increase of bone mass will be seen after 12-18 months of GH treatment.
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