Skeletal maturity was not accelerated by treatment with recombinant growth hormone ( hGH ) .
BACKGROUND Turner syndrome ( TS ) affects about one in 1500 to 2500 live-born females .
One of the most prevalent and salient features of the syndrome is extremely short stature .
Untreated women are approximately 20 to 21 cm shorter than normal women within their respective population s. Recombinant human growth hormone ( hGH ) has been used to increase growth and final height in girls who have Turner syndrome .
OBJECTIVES To assess the effects of recombinant growth hormone in children and adolescents with TS .
Body proportions during long-term growth hormone treatment in girls with Turner syndrome participating in a randomized dose-response trial.
To assess body proportions in girls with Turner syndrome ( TS ) during long term GH treatment , height , sitting height ( SH ) , h and ( H and ) and foot ( Foot ) lengths , and biacromial ( Biac ) and biiliacal ( Biil ) diameters were measured in 68 girls with TS participating in a GH dose-response trial . These previously untreated girls with TS , aged 2 - 11 yr , were r and omly assigned to 1 of 3 GH dosage groups : group A , 4 IU/m2 x day ; group B , first year 4 and thereafter 6 IU/m2 x day ; group C , first year 4 , second year 6 , and thereafter 8 IU/m2 x day . Seven-year data were evaluated to assess the effect of GH treatment on body proportions during childhood . In addition , data from all girls who had reached adult height were evaluated to determine the effect on the adult body proportions . All results were adjusted for age and sex and expressed as SD scores using reference values of healthy Dutch girls . To describe the proportions of SH , H and , Foot , Biac , and Biil to height , these values were adjusted for the SD score of height and were expressed as shape values , using the formula , e.g. for SH : shape SH = ( SH SD score - height SD score)/square root(2 - 2 x correlation coefficient between SH and height in the reference population ) . Furthermore , SD scores using references of untreated girls with TS were calculated for height and SH . Values less than -2 or more than + 2 were considered outside the normal range . At baseline , the shape values of all measurements were significantly higher than zero , but most mean shape values were still within the normal range . Seven-year data of 64 girls and adult height data of 32 girls showed that an increase in height was accompanied by an even higher increase in Foot , result ing in mean SD scores above zero and shape values of + 2 and higher . The increase in the shape value of Foot was significantly higher in groups B and C compared to that in group A after 7 yr of GH treatment , but there were no significant differences between the GH dosage groups in the girls who had reached adult height . The shape values of SH had decreased to values closer to zero after reaching adult height , especially in group A. A similar pattern in the relationship of SH to height was seen using references of girls with TS . No significant changes in the other proportions were found after reaching adult height . In conclusion , on the average , untreated girls with TS have relatively large trunk , h and s , and feet , and broad shoulders and pelvis compared to height . The increase in height after long term GH treatment is accompanied by an even higher increase in Foot and a moderate improvement of the disproportion between height and SH . Recently published reference data from untreated adults with TS and the results of a different patient group receiving a comparable GH dosage suggest that the disproportionate growth of feet has to be considered a part of the natural development in TS , but might be influenced by higher GH dosages . The development of large feet can play a role in the decision of the girl to discontinue GH treatment in the last phase of growth
Skeletal maturity was not accelerated by treatment with recombinant growth hormone ( hGH ) .
BACKGROUND Turner syndrome ( TS ) affects about one in 1500 to 2500 live-born females .
One of the most prevalent and salient features of the syndrome is extremely short stature .
Untreated women are approximately 20 to 21 cm shorter than normal women within their respective population s. Recombinant human growth hormone ( hGH ) has been used to increase growth and final height in girls who have Turner syndrome .
OBJECTIVES To assess the effects of recombinant growth hormone in children and adolescents with TS .