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54 When exploring the link between increasing hemoglobin (Hb) levels and a concurrent increase in BMD or decrease in fracture rate, a critical factor influencing this association, beyond molecular and genetic factors, appears to be increased vulnerability to fractures due to diminished muscle performance, 58 hindering an adequate and secure posture and gait

Indeed, as noted in the guidelines and consensus statements 9,25,26 , the presence of dysfunction of the GH-IGF-1 axis is suspected when high ( + 2.0) or low ( 2.0) IGF-1 SDS is detected in clinical practice

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