Endocrine Abstracts

Background: Recombinant human GH (rhGH) may improve bone mass in paediatric inflammatory bowel disease (IBD).

Objective: To investigate rhGH on bone and body composition in paediatric IBD.

Method: Bone biomarkers were evaluated in 12 children, 11CD (10M), median age 14.4 year (8.9, 16.2) who received rhGH (0.067 mg/kg per day) as part of a 6 months RCT. Eight received rhGH for 24 months and had DXA evaluation. Results were reported as median (range).

Results: Markers of osteoblastic function, P1NP and RANKL, increased significantly at T+6: PINP 204 μg/l (21, 250) at T+0 to 240 μg/l(174, 250) at T+6 (P=0.01), RANKL 0.35 pmo/l (0.1, 0.7) at T+0 to 0.56 pmol/l (0.2, 1.2) at T+6 (P=0.04). Markers of osteoclastic function, urinary CTX, also increased from 6625 mg/l (1800, 8780) at T+0 to 9575 mg/l (5450, 9900) at T+6 (P=0.01). There were no changes in CRP, ESR, TNFα, IL1β, IL6, and interferon over the 6 months. Percentage change in P1NP was negatively associated with percentage change in IL6 (r=0.60, P=0.03). LS BMD for bone age SDS was −1.7 (−2.2, −0.2) at T+0, −1.5 (−2.2, −0.2) at T+6 (vs T+0, P=1.0), −1.5(−1.9, 0.2) at T+12 (vs T+0, P=0.09), and −1.9 (−2.4, 0.1) at T+24 (vs T+0, P=0.86). There were no significant differences in LS BMD for height SDS and BMC for bone area SDS over the 24 months. Lean mass for height centile was 28 (0.0, 87) at T+0, 39.5 (7, 56) at T+6 (vs T+0, P=0.80), 33 (8, 88) at T+12 (vs T+0, P=0.08), and 25 (11, 58) at T+24 (vs T+0, P=0.80).

Conclusion: Short term treatment with rhGH in paediatric IBD was associated with increase in bone turnover but did not lead to improvement in bone mass and body composition in the long term.