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International Journal of Endocrinology
Volume 2014 (2014), Article ID 235060, 25 pages
http://dx.doi.org/10.1155/2014/235060
Review Article

Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis

1Department of Health Sciences, School of Medicine, University of Milano Bicocca, Milan, Italy
2Endocrinology Department, Area Vasta N. 1, Cagli, Italy

Received 13 March 2014; Revised 17 June 2014; Accepted 18 June 2014; Published 23 July 2014

Academic Editor: Robert D. Murray

Copyright © 2014 Vittorio Locatelli and Vittorio E. Bianchi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Growth hormone (GH) and insulin-like growth factor (IGF-1) are fundamental in skeletal growth during puberty and bone health throughout life. GH increases tissue formation by acting directly and indirectly on target cells; IGF-1 is a critical mediator of bone growth. Clinical studies reporting the use of GH and IGF-1 in osteoporosis and fracture healing are outlined. Methods. A Pubmed search revealed 39 clinical studies reporting the effects of GH and IGF-1 administration on bone metabolism in osteopenic and osteoporotic human subjects and on bone healing in operated patients with normal GH secretion. Eighteen clinical studies considered the effect with GH treatment, fourteen studies reported the clinical effects with IGF-1 administration, and seven related to the GH/IGF-1 effect on bone healing. Results. Both GH and IGF-1 administration significantly increased bone resorption and bone formation in the most studies. GH/IGF-1 administration in patients with hip or tibial fractures resulted in increased bone healing, rapid clinical improvements. Some conflicting results were evidenced. Conclusions. GH and IGF-1 therapy has a significant anabolic effect. GH administration for the treatment of osteoporosis and bone fractures may greatly improve clinical outcome. GH interacts with sex steroids in the anabolic process. GH resistance process is considered.