ECE2006 Poster Presentations Bone (46 abstracts)
Effects of growth hormone administration on parathyroid hormone sensitivity and bone mineral metabolism in established osteoporosis
F Joseph 1 , A Ahmad 1 , HD White 1 , A Joshi 1 , B Durham 3 , S Vinjamuri 2 , K Ashawesh 1 , WD Fraser 3 & JP Vora 1
1Department of Diabetes and Endocrinology, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, United Kingdom; 2Department of Nuclear Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, United Kingdom; 3Department of Clinical Chemistry, Duncan Building, Royal Liverpool University Hospital, Prescot Street, Liverpool. L7 8XP, United Kingdom.
Introduction: The beneficial effect of GH replacement on bone in AGHD patients is mediated by improvements in target organ sensitivity to PTH and phosphocalcium metabolism. In aging women with established osteoporosis, GH and IGF-1 concentrations are lower and administration of GH has been shown to increase bone turnover and BMD, but the mechanisms remain unclear.
Methods: Fourteen postmenopausal women (63.4±2.1 years; mean BMD T score ± S.E.M.: lumbar spine (L2–L4) −3.3±0.2, femoral neck −2.0±0.2 were commenced on daily subcutaneous GH. Patients were hospitalised for 24 hours before then 1 and 3 months following GHR. Half-hourly blood and 3-hourly urine samples were collected for PTH, calcium, phosphate, NcAMP (marker of renal PTH activity), CTX (bone resorption marker) and PINP (bone formation marker). 1,25(OH)2D3 were measured on 0800 h fasting samples.
Results: IGF-1 concentrations increased following 1 and 3 months of GH(P<0.001). The 24-h mean PTH concentration decreased from 5.41±0.08 pmol/l to 5.19±0.07 pmol/l at 1 month and 4.99±0.06 pmol/l at 3 months (P<0.001) and the NcAMP increased from 17.62±1.19 nmol/l GFR to 25.11±2.58 nmol/l GFR (P<0.05) and 28.62±1.39 nmol/l GFR (P<0.01) at 1 and 3 months respectively. The 24-h mean adjusted serum calcium and phosphate concentration increased at 1 and 3 months. An increase in 24 h UCa excretion was observed at 3 months (P<0.05) and the TmPO4/GFR increased following 1 and 3 months (P<0.001). 1,25(OH)2D3 concentration increased following 3 months of GH. CTX and PINP concentarations increased at 1 and 3 months (P<0.001) but the percentage increase in PINP was greater than CTX (P<0.01).
Conclusion: GH administration to aging osteoporotic women improves PTH sensitivity with increases in serum 1,25(OH)2D3, calcium and phosphate concentration as well as an increase in TmPO4/GFR. These changes and a greater increase in bone formation may explain the previously demonstrated increase in BMD following long term administration of GH in aging women with osteoporosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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