Vnitr Lek 2024, 70(5):E16-E20 | DOI: 10.36290/vnl.2024.067

Growth hormone secretion disorders and their impact on bone quality

Juraj Payer1, Peter Jackuliak1, Peter Vaňuga1, 2, Martin Kužma1
1 V. interná klinika LFUK a UNB, Bratislava
2 Národný endokrinologický a diabetologický ústav, Ľubochňa

In this article, we address endocrine-mediated osteoporosis caused by disorders of growth hormone (GH) secretion; growth hormone deficiency in adults and acromegaly. GH and insulin-like growth factor-1 (IGF-1) stimulate linear bone growth through complex hormonal interactions and activate epiphyseal prechondrocytes. GH stimulates the production of osteoprotegerin and its accumulation in the bone matrix through the receptor activator of nuclear factor-kappaB (RANK), its ligand (RANK-L) and the osteoprotegerin system. Incorrect function of this mechanism can lead to specific bone damage. The primary problem of bone involvement in disorders of GH secretion is the risk of osteoporotic fractures, so it is important to assess the quality of the bone, which better reflects the actual predisposition of the patient to fracture. The method for estimating bone quality from DXA scans of the lumbar spine is the trabecular bone score (TBS). In acromegaly, TBS better defines fracture risk because BMD is normal or even elevated. TBS helps to monitor the effect of treatment with growth hormone and vitamin D. Despite these findings, TBS should not be used alone, but a comprehensive consideration of all fracture risk factors, BMD and markers of bone turnover is required.

Keywords: growth hormone, insulin-like growth factor-1, bone, bone microstructure, trabecular bone score.

Accepted: August 28, 2024; Published: September 4, 2024  Show citation

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Payer J, Jackuliak P, Vaňuga P, Kužma M. Growth hormone secretion disorders and their impact on bone quality. Vnitr Lek. 2024;70(5):E16-20. doi: 10.36290/vnl.2024.067.
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