Introduction. Previous data from our group suggested a role for the GH/IGF-I axis in the pathophysiology of osteoporosis in thalassemia (Clin Endocrinol 69:202, 2008). The present study was aimed at evaluating the relationships between circulating somatomedins and bone metabolism and density in a very large series of adult thalassemic patients. Study design. One hundred and thirty-nine patients affected by thalassemia major (mean age 32.3 ± 7.87 years) underwent the following evaluations: assessment of lumbar and femoral BMD by DEXA; measurement of serum osteocalcin and CTx, and urinary NTx; measurement of serum IGF-I and IGF-II; assessment of the GH response to GHRH + arginine. Results. Lumbar osteoporosis and femoral osteoporosis were detected in 54.3% and 58.1% of patients, respectively. IGF-I was low in 86.7% of subjects, whereas none of them displayed low IGF-II. Severe GH deficiency was documented in 27.9% of subjects. In the whole group of patients, IGF-I was positively correlated with GH peak (p < 0.01), osteocalcin (p < 0.0001), CTx (p < 0.0001) and NTx (p < 0.0001), and negatively correlated with age (p < 0.0001), but was not correlated with either lumbar or femoral T-scores. No correlations were found between IGF-II and any of the above parameters, with the exception of age (negative correlation, p < 0,05). The same picture of correlations held true when considering the subset of osteoporotic patients. Conclusions. Our study confirms the high prevalence of both osteoporosis and GH/IGF-I deficiency in thalassemic adults. GH and IGF-I secretory status, but not circulating IGF-II, appears to positively affect bone turnover in this clinical condition. Further, GH secretory status, but not circulatin IGFs, is likely to influence also bone mineralization.

STATO SECRETORIO DI GH E SOMATOMEDINE CIRCOLANTI NELLA TALASSEMIA: INFLUENZA SU TURNOVER E DENSITA' MINERALE OSSEA / A. Cattaneo ; tutor: M. Scacchi : coordinatore: P. Beck Peccoz. Universita' degli Studi di Milano, 2012 Feb 13. 24. ciclo, Anno Accademico 2011. [10.13130/cattaneo-agnese_phd2012-02-13].

STATO SECRETORIO DI GH E SOMATOMEDINE CIRCOLANTI NELLA TALASSEMIA: INFLUENZA SU TURNOVER E DENSITA' MINERALE OSSEA

A. Cattaneo
2012

Abstract

Introduction. Previous data from our group suggested a role for the GH/IGF-I axis in the pathophysiology of osteoporosis in thalassemia (Clin Endocrinol 69:202, 2008). The present study was aimed at evaluating the relationships between circulating somatomedins and bone metabolism and density in a very large series of adult thalassemic patients. Study design. One hundred and thirty-nine patients affected by thalassemia major (mean age 32.3 ± 7.87 years) underwent the following evaluations: assessment of lumbar and femoral BMD by DEXA; measurement of serum osteocalcin and CTx, and urinary NTx; measurement of serum IGF-I and IGF-II; assessment of the GH response to GHRH + arginine. Results. Lumbar osteoporosis and femoral osteoporosis were detected in 54.3% and 58.1% of patients, respectively. IGF-I was low in 86.7% of subjects, whereas none of them displayed low IGF-II. Severe GH deficiency was documented in 27.9% of subjects. In the whole group of patients, IGF-I was positively correlated with GH peak (p < 0.01), osteocalcin (p < 0.0001), CTx (p < 0.0001) and NTx (p < 0.0001), and negatively correlated with age (p < 0.0001), but was not correlated with either lumbar or femoral T-scores. No correlations were found between IGF-II and any of the above parameters, with the exception of age (negative correlation, p < 0,05). The same picture of correlations held true when considering the subset of osteoporotic patients. Conclusions. Our study confirms the high prevalence of both osteoporosis and GH/IGF-I deficiency in thalassemic adults. GH and IGF-I secretory status, but not circulating IGF-II, appears to positively affect bone turnover in this clinical condition. Further, GH secretory status, but not circulatin IGFs, is likely to influence also bone mineralization.
13-feb-2012
Settore MED/13 - Endocrinologia
THALASSEMIA ; BONE MINERALIZATION ; GH; IGFI; IGFII
BECK PECCOZ, PAOLO LUIGI MARIA
BECK PECCOZ, PAOLO LUIGI MARIA
Doctoral Thesis
STATO SECRETORIO DI GH E SOMATOMEDINE CIRCOLANTI NELLA TALASSEMIA: INFLUENZA SU TURNOVER E DENSITA' MINERALE OSSEA / A. Cattaneo ; tutor: M. Scacchi : coordinatore: P. Beck Peccoz. Universita' degli Studi di Milano, 2012 Feb 13. 24. ciclo, Anno Accademico 2011. [10.13130/cattaneo-agnese_phd2012-02-13].
File in questo prodotto:
File Dimensione Formato  
phd_unimi_R08074.pdf

accesso aperto

Tipologia: Tesi di dottorato completa
Dimensione 526.17 kB
Formato Adobe PDF
526.17 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/170628
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact