DOSE-DEPENDENT EFFECT OF GROWTH-HORMONE THERAPY ON GLUCOSE-METABOLISMIN SUBJECTS WITH TURNER SYNDROME

Recombinant human growth hormone (GH) is effective in promoting growth velocity in subjects with Turner syndrome. As higher doses are used f or this indication than for substitution therapy in GH deficiency, the long-term effects of GH therapy on carbohydrate metabolism represent a safety issue; this is particularly important in Turner syndrome, in which there is an increased prevalence of impaired glucose tolerance. So far, GH therapy has been given to patients with Turner syndrome for up to 7 years without any significant changes having been reported in glycosylated haemoglobin (HbA1c) values, unstimulated and stimulated oral glucose tolerance test (OGTT) blood glucose and serum insulin con centrations. These findings may, however, be influenced by other varia bles, such as study design, number of subjects or standardization meth ods applied. Results of an ongoing trial in the FRG, from which 2 year s' data on glucose metabolism (as assessed by serial OGTTs) of 72 pati ents with Turner syndrome are available, indicate that glucose homoeos tasis is maintained at the expense of an increase in insulin secretion , which is time- and dose-dependent. Although these changes may be ful ly reversible on withdrawal of GH. therapy, accurate control of glucos e metabolism both during and after GH. treatment is advocated.