ADULT HEIGHT IN GIRLS WITH TURNER SYNDROME TREATED WITH LOW-DOSE ESTROGENS AND ANDROGENS

OBJECTIVE: To determine if low dosages of estrogens and androgens admi nistered to girls with Turner syndrome adversely affected their adult height. DESIGN: A nonrandomized control trial of nine girls. SETTING: The endocrine clinic at Texas Children's Hospital in Houston, Texas, a n academic referral center. PARTICIPANTS: Participants had chromosomal defects consistent with Turner syndrome. Informed consent was obtaine d in accordance with institutional review board procedures. Eligibilit y criteria included an absence of previous hormone treatment. No one w ithdrew from this study because of adverse effects. INTERVENTIONS: Hor monal replacement therapy was initiated with conjugated estrogen 0.15 mg and fluoxymesterone 1 mg administered daily. MAIN OUTCOME MEASURES: Outcome measurements were a comparison of the final heights following treatment versus the predicted adult heights prior to treatment. RESU LTS: The predicted adult height in these children prior to treatment w as 140.0 +/- 4.4 cm (mean +/- SD); the actual adult height was 139.63 +/- 4.1 cm. The difference was 0.37 +/- 3.54 cm, which was not statist ically significant by Wilcoxon signed-rank test (p=0.23). The 95% conf idence interval on this difference ranged from -3.1 to 2.3 cm, which i ndicates a true mean height loss of no more than 3.1 cm or a true mean gain of no more than 2.3 cm. CONCLUSIONS: Our results indicate that h ormone replacement therapy with low dosages of conjugated estrogens an d androgens starting at 10-11 years of age in children with Turner syn drome does not adversely affect actual adult height.