Bone mineral density and effects of growth hormone treatment in prepubertal children with Prader-Willi syndrome: a randomized controlled trial

Roderick F A de Lind van Wijngaarden, Dederieke A M Festen, Barto J Otten, Edgar G A H van Mil, Joost Rotteveel, Roelof J Odink, Mariëtte van Leeuwen, Danny A J P Haring, Gianni Bocca, E C A Mieke Houdijk, Anita C S Hokken-Koelega

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BACKGROUND: Bone mineral density (BMD) is unknown in children with Prader-Willi syndrome (PWS), but is decreased in adults with PWS. In patients with GH deficiency, BMD increases during GH treatment.

OBJECTIVES: The aim of the study was to evaluate BMD in children with PWS and to study the effects of GH treatment.

DESIGN: We conducted a randomized controlled GH trial. Forty-six prepubertal children were randomized into either a GH-treated group (1.0 mg/m(2) . d) or a control group for 2 yr. At start, 6, 12, and 24 months of study, total body and lumbar spine BMD were measured by dual-energy x-ray absorptiometry, and lumbar spine bone mineral apparent density (BMAD) was calculated.

RESULTS: Baseline total body and lumbar spine BMD sd score (SDS) were normal [mean (sd), -0.2 SDS (1.1) and -0.4 SDS (1.2), respectively]. BMADSDS, which corrects for short stature, was also normal [mean (sd), 0.40 SDS (1.1)]. Total body BMDSDS decreased during the first 6 months of GH (P < 0.0001), but increased during the second year of treatment. After 24 months of study, total body and lumbar spine BMDSDS, and the BMADSDS did not significantly differ between GH-treated children and randomized controls (P = 0.30, P = 0.44, and P = 0.47, respectively). Results were similar when corrected for body mass index SDS. Repeated measurements analysis showed a significant positive association between IGF-I SDS and total body and lumbar spine BMDSDS, but not with BMADSDS.

CONCLUSIONS: Our results show that prepubertal children with PWS have a normal BMD. GH treatment had no effect on BMD, except for a temporary decrease of total body BMDSDS in the first 6 months.

Original languageEnglish
Pages (from-to)3763-71
Number of pages9
JournalJournal of Clinical Endocrinology & Metabolism
Issue number10
Publication statusPublished - Oct 2009
Externally publishedYes


  • Absorptiometry, Photon
  • Bone Density/drug effects
  • Child
  • Female
  • Human Growth Hormone/pharmacology
  • Humans
  • Lumbar Vertebrae/metabolism
  • Male
  • Prader-Willi Syndrome/drug therapy
  • Puberty
  • Treatment Outcome

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