Isolated GH deficiency due to a GHRH receptor mutation causes hip joint problems and genu valgum, and reduces size but not density of trabecular and mixed bone

Carlos C. Epitácio-Pereira, Gabriella M.F. Silva, Roberto Salvatori, João A.M. Santana, Francisco A. Pereira, Miburge B. Gois-Junior, Allan V.O. Britto, Carla R.P. Oliveira, Anita H.O. Souza, Elenilde G. Santos, Viviane C. Campos, Rossana M.C. Pereira, Eugênia H.O. Valença, Rita A.A. Barbosa, Maria Isabel T. Farias, Francisco J.A. De Paula, Taisa V. Ribeiro, Mario C.P. Oliveira, Manuel H. Aguiar-Oliveira

Research output: Contribution to journalArticlepeer-review

Abstract

Context: The GH/IGF-I axis is important for bone growth, but its effects on joint function are not completely understood. Adult-onset GH-deficient individuals have often reduced bone mineral density (BMD). However, there are limited data on BMD in adult patients with untreated congenital isolated GH-deficient (IGHD). We have shown that adult IGHD individuals from the Itabaianinha, homozygousfor the c.57+1G>AGHRHRmutation, have reducedbonestiffness, butBMDand joint status in this cohort are unknown. Objective: The goal is to study BMD, joint function, and osteoarthritis score in previously untreated IGHD adults harboring the c.57+1G>A GHRHR mutation. Design: This is a cross-sectional study. Methods: Areal BMD by dual-energy X-ray absorptiometry was measured in 25 IGHD and 23 controls (CO). VolumetricBMD(vBMD) was calculated at the lumbar spine and total hip. Joint function was assessed by goniometry of elbow, hips, and knees. X-rays were used to measure the anatomic axis of knee and the severity of osteoarthritis, using a classification for osteophytes (OP) and joint space narrowing (JSN). Results: Genu valgum was more prevalent in IGHD than CO. The osteoarthritis knees OP score was similar in both groups, and knees JSN score showed a trend to be higher in IGHD. The hips OP score and JSN score were higher in IGHD. Areal BMD was lower in IGHD than CO, but vBMD was similar in the two groups. Range of motion was similar in elbow, knee, and hip in IGHD and CO. Conclusions: Untreated congenital IGHD due to a GHRHR mutation causes hip joint problems and genu valgum, without apparent clinical significance, reduces bone size, but does not reduce vBMD of the lumbar spine and hip.

Original languageEnglish (US)
Pages (from-to)E1710-E1715
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number11
DOIs
StatePublished - Nov 1 2013

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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