Endocrine Abstracts (2006) 11 P23

The reduction of bone mineral density in post-menopausal women with primary hyperparathyroidism is higher in the presence of concomitant GH hormone secretion impairment

E Cecconi1, M Genovesi1, F Bogazzi1, L Grasso1, M Procopio2, C Marcocci1, A Pinchera1, L Bartalena3, E Martino1 & M Gasperi1

1Università di Pisa, Pisa, Italy; 2Università di Torino, Torino, Italy; 3Università dell’Insubria, Varese, Italy.

Primary hyperparathyroidism (PHP) and growth hormone deficiency (GHD) are both associated with alterations of bone metabolism.

GH secretion is frequently impaired in PHP patients; thus GH/IGF-I system alterations could be involved in the pathogenesis of osteoporosis.

In the present study 50 post-menopausal women with PHP were evaluated by GH response to GH-releasing hormone (GHRH)+arginine (ARG) test and femoral neck bone mineral density (BMD, g/cm2) by dual energy X-ray absorptiometry. BMI, serum ionised calcium, PTH and markers of bone remodelling (serum osteocalcin (OC), serum bone-specific alkaline phosphatase (B-AP), serum cross-laps (S-CTX) were evaluated as well.

Same data were collected in a group of 60 age-matched controls.

No difference was found between the two groups regarding age, age at menopause, BMI, serum ionised calcium, PTH and IGF-I concentrations.

GH secretion was reduced (mean GH response to GHRH+arg test: 8.8±4.2 μg/liter) in 34 patients and normal (28.7±11.8 μg/liter) in the remaining 16 (P<0.05), in the control group peak GH was 33.8±10.9 μg/liter.

Osteoporosis (T-score <−2.5) and osteopenia (T-score >−2.5 and <−1) were found in 73.5% and 17.6% of GHD patients, in 37.5% and 43.7% of patients with normal GH secretion and 3.1% and 27% of controls.

The prevalence of osteoporosis in GHD group was significantly different with respect to patients with normal GH secretion (P=0.02) and to controls (P=0.02).

T-score was not correlated with ionised calcium, nor with age, age at menopause or BMI, but was correlated with PTH serum levels in both groups and T-score was correlated with markers of bone remodelling only in GHD patients.

In conclusion, impairment of GH secretion could be involved as a pathogenetic factor in bone metabolism alterations of PHP.