{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:29:51Z","timestamp":1790785791083,"version":"4.1.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2007,12,1]],"date-time":"2007-12-01T00:00:00Z","timestamp":1196467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Fracture risk in GHD patients is not definitely established. Studying fracture incidence in 832 patients on GH therapy and 2581 matched population controls, we recorded a doubled fracture risk in CO GHD women, but a significantly lower fracture risk in AO GHD men.<\/jats:p>\n               <jats:p>Introduction: The objective of this study was to evaluate fracture incidence in patients with confirmed growth hormone deficiency (GHD) on replacement therapy (including growth hormone [GH]) compared with population controls, while also taking potential confounders and effect modifiers into account.<\/jats:p>\n               <jats:p>Materials and Methods: Eight hundred thirty-two patients with GHD and 2581 matched population controls answered a questionnaire about fractures and other background information. Incidence rate ratio (IRR) and 95% CI for first fracture were estimated. The median time on GH therapy for childhood onset (CO) GHD men and women was 15 and 12 yr, respectively, and 6 and 5 yr for adult onset (AO) GHD men and women, respectively.<\/jats:p>\n               <jats:p>Results: A more than doubled risk (IRR, 2.29; 95% CI, 1.23\u20134.28) for nonosteoporotic fractures was recorded in women with CO GHD, whereas no risk increase was observed among CO GHD men (IRR, 0.61) and AO GHD women (IRR, 1.08). A significantly decreased incidence of fractures (IRR, 0.54; 95% CI, 0.34\u20130.86) was recorded in AO GHD men.<\/jats:p>\n               <jats:p>Conclusions: Increased fracture risk in CO GHD women can most likely be explained by interaction between oral estrogen and the GH\u2013IGF-I axis. The adequate substitution rate of testosterone (90%) and GH (94%) may have resulted in significantly lower fracture risk in AO GHD men.<\/jats:p>","DOI":"10.1359\/jbmr.070811","type":"journal-article","created":{"date-parts":[[2007,8,28]],"date-time":"2007-08-28T12:10:00Z","timestamp":1188303000000},"page":"1842-1850","source":"Crossref","is-referenced-by-count":59,"title":["Fracture Incidence in GH-Deficient Patients on Complete Hormone Replacement Including GH"],"prefix":"10.1093","volume":"22","author":[{"given":"Helene","family":"Holmer","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes, Lund University Hospital, Lund, Sweden"},{"name":"Department of Internal Medicine, Centralsjukhuset, Kristianstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Svensson","sequence":"additional","affiliation":[{"name":"Research Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Gothenburg, 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