Recombinant growth hormone treatment, osteoporosis and fractures, more complicated than it seems!

Excerpt

Growth hormone (GH) effects on skeletal development are well recognized. GH promotes longitudinal bone growth during childhood and attainment of adult bone mass [1, 2]. However, GH also plays a role in adult skeletal mass maintenance. Insulin-like growth factor 1 (IGF-1) influences development and function of several skeletal cell lineages. Independently of IGF-1, GH stimulates chondrocytes and osteoblasts; precursors of proliferation and differentiation. Simultaneously, bone resorption is mainly stimulated by IGF-1, whereas GH negatively modulates this effect by inducing the synthesis of osteoprotegerin by osteoblasts. Furthermore, GH may influence parathyroid hormone secretion pattern through phosphate retention, thus further influencing bone remodeling. …