THE INFLUENCE OF GROWTH-HORMONE MONOTHERAPY AND GROWTH-HORMONE IN COMBINATION WITH OXANDROLONE OR TESTOSTERONE ON THYROXID HORMONE PARAMETERS AND THYROXIN BINDING GLOBULIN IN PATIENTS WITH ULLRICH-TURNER-SYNDROME

Administration of human growth hormone (GH) has yielded conflicting re sults concerning its role on thyroid function in patients with Ullrich -Turner syndrome. Therefore, we investigated the course of thyroid hor mone parameters and thyroxin binding globulin in relation to GH therap y, IGF-I and additional oxandrolone-(Ox) or testosterone (T) treatment in 20 patients with Ullrich-Turner syndrome. During the Ist year the patients received only GH. There was no change in T4, fT4, and TSH lev els, T3 increased significantly (P < 0.01) after 6 and 12 months, resu lting in a higher T3/T4 ratio. TBG (P < 0.05) and IGF-I (P < 0.01) inc reased after 6 months and remained elevated at 12 months. A significan t positive correlation was found between the change of T4 and TBG afte r 6 months (r = 0.47, P < 0.05) and after 12 months (r = 0.69, P < 0.0 05). Thirteen patients were further investigated after addition of an anabolic compound; 7 received Ox (0.0625 mg/kg/day po) and 6 low dose T (5 mg i.m. every 14 days). Chronological age was comparable in these groups (10.7 +/- 2.7 vs 10.7 +/- 3.6 years). After 6 months of combin ation therapy with Ox, T4, T3 and TSH decreased. As T4 and T3 showed a parallel decrease the T3/T4 ratio remained elevated. TBG declined aft er 6 and 12 months (P < 0.05), while IGF-I showed a further increment (P < 0.05). There was no correlation between the changes in T4 and IGF -I, TSH and TBG, respectively. In the T-treated group only IGF-I incre ased (P < 0.05) to the same extent as in the Ox-treated patients, wher eas the thyroid parameters did not change. Conclusion The observed cha nges in thyroid hormone and TBG levels in the Ox group were not mediat ed by GH or IGF-I. The Ox-induced TBG decrease might be linked to alte red pancreatic functions regulating carbohydrate metabolism.