Lifetime, untreated isolated GH deficiency due to a GH-releasing hormone receptor mutation has beneficial consequences o
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ORIGINAL ARTICLE
Lifetime, untreated isolated GH deficiency due to a GH-releasing hormone receptor mutation has beneficial consequences on bone status in older individuals, and does not influence their abdominal aorta calcification Anita H. O. Souza • Maria I. T. Farias • Roberto Salvatori • Gabriella M. F. Silva • Joa˜o A. M. Santana • Francisco A. Pereira • Francisco J. A. de Paula • Eugenia H. O. Valenc¸a • Enaldo V. Melo • Rita A. A. Barbosa • Rossana M. C. Pereira Miburge B. Gois-Junior • Manuel H. Aguiar-Oliveira
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Received: 4 October 2013 / Accepted: 6 November 2013 Ó Springer Science+Business Media New York 2013
Abstract The GH/IGF-I axis has essential roles in regulating bone and vascular status. The age-related decrease in GH secretion (‘‘somatopause’’) may contribute to osteoporosis and atherosclerosis, commonly observed in the elderly. Adult-onset GH deficiency (GHD) has been reported to be associated with reduced bone mineral density (BMD), increased risk of fractures, and premature atherosclerosis. We have shown the young adult individuals with isolated GHD (IGHD) due to a homozygous for the c.57?1G[A GHRH receptor gene mutation have normal volumetric BMD (vBMD), and not develop premature atherosclerosis, despite adverse risk factor profile. However, the bone and vascular impact of lifetime GHD on the aging process remains unknown. We studied a group of ten older IGHD subjects (C60 years) homozygous for the mutation, comparing them with 20 age- and gender-matched controls (CO). Areal BMD was measured, and vBMD
was calculated at the lumbar spine and total hip. Vertebral fractures and abdominal aortic calcifications (expressed as calcium score) were also assessed. Areal BMD was lower in IGHD, but vBMD was similar in the two groups. The percent of fractured individuals was similar, but the mean number of fractures per individual was lower in IGHD than CO. Calcium score was similar in the two groups. A positive correlation was found between calcium score and number of fractures. Untreated lifetime IGHD has beneficial consequences on bone status and does not have a deleterious effect on abdominal aorta calcification. Keywords Isolated GH deficiency Aging Osteoporosis Vertebral fractures Vascular calcification
Introduction A. H. O. Souza M. I. T. Farias G. M. F. Silva J. A. M. Santana F. A. Pereira E. H. O. Valenc¸a E. V. Melo R. A. A. Barbosa R. M. C. Pereira M. B. Gois-Junior M. H. Aguiar-Oliveira Division of Endocrinology, Department of Medicine, School of Medicine, Federal University of Sergipe, Aracaju, Brazil R. Salvatori (&) Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument street suite #333, Baltimore, MD 21287, USA e-mail: [email protected] F. J. A. de Paula Division of Endocrinology Department of Internal Medicine, School of Medicine of Ribeira˜o Preto, University of Sa˜o Paulo, Ribeira˜o Preˆto, Brazil
Osteoporotic fractures and cardiovascular disease are top ranked public health problems, intimate
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