Bone loss after childhood XXXX : an observational study with and without GH therapy.

@entity1 @entity2338 @entity981 @entity442 @entity170 @entity79
OBJECTIVE: @entity79 ( @entity79 ) in survivors of @entity981 ( @entity981 ) seems to vary with time, type of treatments and GH status. We aimed to evaluate @entity79 in @entity981 @entity1 with @entity2338 ( @entity2338 ), with and without GH therapy. DESIGN: Case-control study. METHODS: We examined 44 (21 @entity1 ) @entity2338 @entity1 (median 25 years) treated with cranial radiotherapy (18-24 Gy) and chemotherapy and matched population controls for @entity79 with dual-energy X-ray absorptiometry. For 5 and 8 years, two subgroups with (0.5mg/day) (n=16) and without GH therapy (n=13) and matched controls were followed respectively. RESULTS: At baseline, no significant differences in @entity79 or Z-scores at femoral neck and L2-L4 were recorded (all P>0.3). After another 8 years with @entity2338 , the Z-scores at femoral neck had significantly decreased compared with baseline (0.0 to -0.5; P<0.03) and became lower at the femoral neck (P=0.05), and at L2-L4 (P<0.03), compared with controls. After 5 years of GH therapy, only female @entity981 @entity1 had a significantly lower femoral neck Z-scores (P=0.03). The female @entity981 @entity1 reached an @entity442 level of -0.7 s.d. and male @entity1 reached the level of +0.05 s.d. CONCLUSIONS: On average, 25 years after diagnosis, GH-deficient @entity981 @entity1 experienced a significant decrease in Z-scores at femoral neck, and if Z-scores continue to decrease, there could be a premature risk for @entity170 . GH therapy was not shown to have a clear beneficial effect on @entity79 . Whether higher GH doses, particularly in @entity1 , will improve Z-scores needs further investigation.
