Endocrine Abstracts

Gonadotropin levels in all Turner syndrome (TS) patients present a diphasic pattern: highest in early childhood, declining at 6–10 years of age, and then increasing again. Here, we have investigated whether karyotype or FSH&LH can be used as indicators of spontaneous puberty in TS. From a consecutive group of 139 TS girls treated at one clinical center (1996–2015) the clinical & biochemical data were finally analyzed in 110 TS patients (1268 visits). The study population was divided into two subsets based on karyotype (type A- 45X, 54%; type B- others excluding 45X/46XY). The mean diagnosis age and duration of follow-up were 10.7±4.0 and 5.9 years, resp. The average number of visits was 10.4. Spontaneous puberty was confirmed in 48.2% and menarche in 20%, both less common in group A than B (31.1% and 9.8.% vs 69.4% and 32.6%, resp., P<0.05). The mean age of Tanner B2 and menarche in all girls were 13.7±2.4 and 14.2 years, no difference between the groups (13.5±2.5 and 13.2±1.0 years (A) vs 13.8±2.3 and 14.6±1.7 years (B), P>0.05). The median FSH and LH values in all patients at the age of 6–10 were 8.16 and 0.35 IU/l resp., significantly lower comparing to younger (44.6 and 0.76 IU/l) and older (93.0 and 16.1 IU/l) age (P<0.0001). LH were similar in both groups, whereas in group B FSH values were significantly higher only in the older age. At the age of 6–10 FSH and LH levels ≥than 6.7 and 0.2 resp. decrease the chance of spontaneous menarche (33.3% vs 13.9% and 28.6% vs 11.8%). Conclusion: Nearly half of our TS patients showed spontaneous puberty symptoms and every fifth had spontaneous menarche with higher frequency in non-45,X girls. The diphasic pattern of FSH&LH was confirmed, however using their cut-off values one can predict the chance for spontaneous menarche.