Wydra Arnika, Czajka-Oraniec Izabella, Wydra Jakub, Zgliczyński Wojciech
Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland.
Department of Internal Medicine, Bielanski Hospital, Warsaw, Poland.
Reumatologia. 2023;61(4):239-247. doi: 10.5114/reum/170244. Epub 2023 Aug 31.
Growth hormone (GH) is a key peptide hormone in the regulation of bone metabolism, through its systemic and paracrine action mediated directly as well as by insulin-like growth factor-1 (IGF-1). Growth hormone exerts pleiotropic effects leading to an increase in linear bone growth, accumulation of bone mineral content and preservation of peak bone mass. Furthermore, it influences protein, lipid, and carbohydrate metabolism.Growth hormone deficiency (GHD) causes a low bone turnover rate leading to reduced bone mineral density (BMD) and increased bone fragility. The results of GH insufficiency are the most pronounced among children as it negatively affects longitudinal bone growth, causing short stature and in adolescents, in whom it hinders the acquisition of peak bone mass. Most studies show that treatment with recombinant human growth hormone (rhGH) in GHD patients could improve BMD and decrease fracture risk. This review aims to summarize the pathophysiology, clinical picture and management of bone complications observed in GHD.
生长激素（GH）是调节骨代谢的关键肽类激素，通过其直接介导的全身作用和旁分泌作用以及胰岛素样生长因子-1（IGF-1）发挥作用。生长激素具有多效性，可导致骨线性生长增加、骨矿物质含量积累以及维持骨峰值。此外，它还影响蛋白质、脂质和碳水化合物代谢。生长激素缺乏症（GHD）会导致骨转换率降低，进而导致骨矿物质密度（BMD）降低和骨脆性增加。生长激素分泌不足的后果在儿童中最为明显，因为它会对骨纵向生长产生负面影响，导致身材矮小；在青少年中，它会阻碍骨峰值的获得。大多数研究表明，重组人生长激素（rhGH）治疗GHD患者可改善骨密度并降低骨折风险。本综述旨在总结GHD中观察到的骨并发症的病理生理学、临床表现和管理。
