C. Dacouvoutetakis et al., THE GROWTH-PATTERN AND FINAL HEIGHT OF GIRLS WITH TURNER-SYNDROME WITH AND WITHOUT HUMAN GROWTH-HORMONE TREATMENT, Pediatrics, 101(4), 1998, pp. 663-668
Background. Shortness is the most frequent and quite disturbing charac
teristic of girls with Turner syndrome (TS). Human growth hormone admi
nistration (hGH) to girls with TS increases growth velocity (GV), but
a favorable effect on final height (FH) has not been documented. The a
im of this study was to evaluate the effect of hGH administration on t
he growth pattern and FH in girls with TS. Methods. The study group wa
s comprised of 123 girls with TS who were tared for in our center. Eig
hty-two of these girls received hGH (mean dose, 0.78 +/- 0.12 IU/kg/we
ek), given subcutaneously 5 to 7 times per week for a period of 2.2 +/
- 1.2 years (hGH group). The mean chronological age (CA) and bone age
(BA) at hGH initiation were 11.5 +/- 25 years and 9.7 +/- 2.3 years, r
espectively. The remaining 41 girls did not receive hGH and are design
ated as the untreated control group. In both groups, gonadal steroids
were given for pubertal initiation and maintenance. Results. The GV du
ring the first year of hGH therapy (GV1) was higher than the year befo
re hGH (6.3 cm/year vs 4.0 cm/year) and higher than the GV of the untr
eated group at a similar CA (4.4 cm/year). The GVs during the second (
GV2) and third (GV3) year of hGH treatment (5.4 and 4.9 cm/year, respe
ctively) were lower, but still higher in the hGH group, in comparison
with the untreated group (GV2, 4.2 cm/year; GV3, 3.4 cm/year). GVI, GV
2 and GV3 were negatively related to age and to BA at hGH initiation.
The FH of the 35 hGH-treated girls was not significantly different fro
m the FH of the 27 untreated girls (146.1 cm vs 144.0 cm). The Delta t
arget height-FH was not significantly different in the two groups. The
FH standard deviation score of the hGH-treated group was positively r
elated to height standard deviation score for CA at treatment initiati
on (r = +0.73), maternal height (r = +0.57), target height (r = + 0.66
), and birth weight (r = +0.54), but was unrelated to CA or BA at star
t of therapy or to hGH dose. Conclusions. hGH therapy in girls with TS
, in the dose and duration of treatment applied in this study, signifi
cantly accelerated GV but did not significantly improve FH.