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Growth Hormone Changes Bone Geometry and Body Composition in Patients with Juvenile Idiopathic Arthritis Requiring Glucocorticoid Treatment: A Controlled Study Using Peripheral Quantitative Computed Tomography

Division of Pediatric Endocrinology, University Children’s Hospital (S.B., W.B., R.D.P., H.P.S.), Munich, Germany; and Children’s Rheumatology Clinic (P.R., R.H.), Garmisch-Partenkirchen, Germany

Address all correspondence and requests for reprints to: Dr. Susanne Bechtold, University Children’s Hospital, Lindwurmstrasse 4, D-80337 Munich, Germany. E-mail: susanne.bechtold{at}med.uni-muenchen.de.

Osteopenia and growth retardation have been described in children with chronic arthritis. GH has an impact on both. In the present controlled study, we used peripheral quantitative computed tomography to evaluate forearm bone mass, density, and geometry as well as forearm muscle and fat area in 17 patients with juvenile idiopathic arthritis (JIA) receiving treatment with GH for 3.8 ± 1.1 yr compared with an untreated age- and sex-matched control group (n = 17). All patients had a mean age of 15.3 ± 2.5 yr and a mean duration of illness of 8.2 ± 4.4 yr. Height, weight, body mass index, bone parameters, and muscle area were significantly decreased in both groups compared with those in healthy age-matched children. Compared with untreated JIA patients, GH-treated JIA patients had significant higher bone mineral content as well as total cross-sectional area (CSA), cortical CSA, and muscle CSA. Fat CSA was lower in the GH-treated group. A significant difference between groups for height-corrected cortical and muscle areas was only seen in male patients. Cortical CSA relative to muscle CSA was not different between groups. These findings are compatible with an anabolic effect of GH on muscle and bone development.

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