Abstract
This study evaluated the effects of recombinant human growth hormone (rhGH) on bone mineral density (BMD) and body composition in Chinese adolescents with transitional growth hormone deficiency (TGHD). A prospective cohort study was conducted from September 2021 to September 2024, involving 37 TGHD patients (15-18 years) and 7 healthy controls. After a 3-month rhGH washout, 9 confirmed TGHD patients (diagnosed per 2019 AACE criteria) were stratified into treatment (n = 4, rhGH continuation) and non-treatment (n = 5) groups. Assessments included dual-energy X-ray absorptiometry (DXA) for BMD and body composition, biochemical profiling, grip strength, and cardiac ultrasound. Statistical analyses utilized SPSS 27.0. At baseline, TGHD patients exhibited elevated lean body mass (63.33 ± 15.58% vs 37.47 ± 2.27%, P = .001) and fat mass (FM) (33.28 ± 7.33% vs 24.93 ± 0.86%, P = .002) compared to controls. After 6 months, rhGH-treated patients demonstrated significant improvements in lumbar BMD (0.74 ± 0.58 vs 0.53 ± 0.12 g/cm2, P < .05) and grip strength (left: 33.20 ± 2.82 vs 21.47 ± 1.25 kg; right: 32.66 ± 4.70 vs 21.66 ± 1.49 kg, P < .05), whereas untreated patients showed BMD decline (0.42 ± 0.55 vs 0.59 ± 0.85 g/cm2, P < .05) and grip deterioration (16.24 ± 2.43 vs 23.84 ± 2.86 kg, P < .05). Untreated TGHD patients developed dyslipidemia, with elevated triglycerides (4.42 ± 0.66 vs 0.94 ± 0.53 mmol/L, P < .05) and LDL-C (5.75 ± 0.97 vs 2.63 ± 0.31 mmol/L, P < .05) versus controls. No significant changes in growth velocity, IGF-1, or cardiac function were observed (P > .05). Continued rhGH therapy during the transitional phase improves BMD, preserves favorable body composition, and mitigates metabolic risks in TGHD patients. Discontinuation exacerbates musculoskeletal deficits and lipid abnormalities, underscoring the necessity of sustained GH replacement until peak bone mass attainment. These findings highlight the critical role of rhGH beyond linear growth optimization in TGHD management.