Long-term effects of growth hormone therapy on bone mineral density, body composition, and serum lipid levels in growth hormone deficient children: A 6-year follow-up study

Aim: To study the effects of growth hormone (GH) deficiency (GHD) and GH replacement therapy (GHRx) on bone mineral density (BMD) and body composition. Methods: 59 GHD children participated (age range 0.4-16.9 years); the follow-up period was 6 years. Lumbar spine BMD (BMD_LS), total-body BMD (BMD_TB), and body composition were measured prospectively using dual-energy X-ray absorptiometry. Results: Mean BMD_LS and BMD_TB were significantly reduced at the time of the diagnosis. The bone mineral apparent density of the lumbar spine (BMAD_LS) was reduced to a lesser degree. The BMAD_LS increased to normal values after 1 year; BMD_LS and BMD_TB normalized 1 year later. At the time of the diagnosis, the lean body mass was reduced and steadily increased during GHRx. Percentage of body fat was increased at baseline and normalized within 6 months. The severity of GHD was not associated with the BMD at diagnosis or the response to GHRx. Conclusion: Areal BMD_LS and BMD_TB and, to a lesser extent, BMAD_LS are decreased in GHD children, but normalize within 1-2 years.