Endocrine Abstracts

Introduction: The treatment with growth hormone (GH) plays an essential role in the Turner syndrome (TS) management. This study evaluated its efficacy in improving adult height (AH) and metabolic parameters.

Material and methods: We retrospectively analysed auxological, biochemical, genetic and pharmacological parameters of 56 girls with confirmed TS. They were categorised according to their karyotype as X monosomy (62%), isochromosome (17%), X mosaicism (11%) and ring X chromosome (10%). They were aged 10.85 ±4.008 years at the initiation of the treatment, and the average GH treatment duration was 4.36 ± 2.82 years with a dose of 0.035-0.05 mg/kg/day.

Results: The GH treatment significantly increased height between the first and the last visit (123.36 ± 17.78 cm vs 150.45 ± 7.37 cm). There was a significant correlation between the initial age and the final height. IGF1 serum level was low in 15 patients before treatment and raised to normal values during treatment. Nine patients were overweight and the BMI did not significantly change during treatment. The total cholesterol and triglycerides decreased after the initiation of the treatment (from 173.87 ± 27.59 mg/dl to 155.69 ± 31.06 mg/dl and 79.25 ± 44.07 to 75.6 ± 34.61). Fasting plasma glucose raised from 87.53 ± 10.57 to 93.85 ± 9.35 mg/dl, with only a few isolated cases of hyperglycemia (6 patients). There was no significant change in terms of hepatic enzymes during treatment. Vitamin D deficiency was identified in 17 patients (16.13 ± 4.3 ng/ml). Eleven girls (19.6%) presented autoimmune thyroiditis, ten girls - cardiac anomalies, 2 - renal malformation and 4 - celiac disease. The treatment had no negative impact on cardiac function.

Conclusion: Our study strengthens the literature findings that GH treatment at an early age effectively improves the final height. GH therapy has additional positive effects on serum lipids, without adverse effects on carbohydrate metabolism, hepatic function or cardiac modifications, confirming treatment safety in TS girls.