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Objective: Discontinuation of growth hormone therapy (rhGH) upon completion of linear growth may adversely affect bone mineral density and content (BMD/BMC) in adolescents with childhood-onset GH deficiency (CO-GHD) and predisposition to osteoporosis. Although the benefits of weight-dependent somatropin high doses over bone gain are established, little is known about fixed low doses. We analyzed the impact of non-weight-based low-dose somatropin on bone accrual during the transition among CO-DGH patients, treated since childhood., Methods: Lumbar spine (LS) and whole-body (WB) BMD and BMC were measured at baseline and after 18 months in 54 adolescents (age: 16.8 ± 1.6 years). They were retested and reclassified as GH sufficient (GHS, n = 28) and GH insufficient. The last group was later randomized to use rhGH (GH on; n = 15) or no treatment (GH off, n = 11) in this single-center open-label study. The average dose of rhGH was 0.5 ± 0.18 mg/day., Results: When comparing the groups, the GH off group had a lower percentage change in LS BMD than the GHS (0.53 % ± 5.9 vs. 4.42 % ± 4.1, respectively, p < 0.04). However, in the analysis of the GH on and off subgroups, the LS BMC percentage change was higher in the GH on (11.02 % ± 10.12 vs. 2.05 % ± 10.31, respectively, p < 0.04)., Conclusion: Non-weight-based low-dose somatropin withdrawal for 18 months limits bone accrual in LS of CO-DGH subjects in transition, predisposing them to osteoporosis in adult life., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Objective: The main growth hormone action is to promote linear growth increasing protein synthesis stimulation and osteoblastic activity. Peak bone mass extends from adolescence to 30 years of age. Several factors may influence this acquisition and prevent fracture risk in adulthood, such as genetic potential, GH, ethnicity, and lifestyle factors. This study aims to compare bone mass and osteometabolic profile of white and Afro-descendant Brazilian adolescents in the transition phase, who were treated with human recombinant growth hormone in childhood., Methods: The authors selected 38 adolescents from the Transition Outpatient Clinic of the University of São Paulo. Lumbar spine and total body bone mineral density (BMD) and bone mineral content (BMC), serum calcium, 25-OH-vitamin D and bone markers were analyzed at the rhGH withdrawal., Results: The mean age was 16.8 ± 1.6 years. There were 21 Afro-descendant and 17 whites. Thirty-four percent of the sample presented vitamin D insufficiency, 66% inadequate calcium intake and 44.7% physical inactivity. The Afro-descendants showed a lower lumbar spine and total body Z scores than those of the whites (p = 0.04 and p = 0.03, respectively), as well as their mean body weight (p = 0.03). There were no differences in the remaining osteometabolic parameters., Conclusion: As most adolescents had vitamin D insufficiency, low calcium intake, and physical inactivity, calcium, and cholecalciferol supplementation and lifestyle changes should be encouraged. The Brazilian Afro-descendant may be a vulnerable group for low bone mass, requiring special strategies to increase bone accrual and body weight. More studies are necessary to compare ethnic differences in this population., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2022. Published by Elsevier Editora Ltda.)