Endocrine Abstracts (2013) 32 P631 | DOI: 10.1530/endoabs.32.P631

GH therapy in Turner syndrome: growth rate indirectly correlated with age of therapy initiation

Ioana Hristov1, Ramona Elena Axinte1, Cristina Preda1,2, Maria Christina Ungureanu1,2 & Voichita Mogos1,2

1St Spiridon Hospital, Iasi, Romania; 2University of Medicine and Pharmacy: ‘Gr.T.Popa’, Iasi, Romania.

Introduction: Short stature is the most common physical abnormality in Turner syndrome (TS), with adult stature averaging 20 cm shorter compared to the general population.

Aim: To study the efficiency of early initiation for GH therapy on final stature for patients with Turner syndrome and to prove it’s important role in obtaining optimal growth rates.

Methods: We studied a lot of 24 patients with TS diagnosed and followed up in our Department of Endocrinology. The most frequently congenital malformations associated with Turner syndrome were:

Congenital heart diseases (seven cases), Hypothyroidism (five cases) and Structural malformations of the kidneys (five cases).

Considering the diagnosis age for Turner syndrome, four categories were defined: i) 0–5 years: 5% (two patients), ii) 5–10 years: 36% (eight patients), iii) 10–15 years: 36% (eight patients), iv) 15–20 years: 23% (six patients). Recombined GH therapy was initiated for the last three categories.

Results: The growth rates were significant in the three groups:

i)age 5–10 years: average growth rate: 0.736 cm/month (18 months follow-up); average initial stature: 113.3 cm; mean total height gain:11.7 cm

ii)age 10–15 years: average growth rate:0.561 cm/month (mean follow-up 24 months); average initial stature: 124.6 cm; mean total height gain: 15.0 cm

iii)age 15–20 years: average growth rate:0.278 cm/month (mean follow-up 18 months); average initial stature 137.6 cm; mean total height gain: 4.6 cm

Conclusions: Comparing the growth curves and growth velocity in the three groups we notice that growth rates decrease with late therapy initiation, which becomes an important factor for the final stature prognosis. Longer follow-up is important for evaluating the efficiency of early initiated GH therapy.

Discussion: In patients group of 15–20 years, we obtained the lowest growth rates, the incriminated factor being the associated substitutive oestrogen therapy and it’s effects on the bone plate.

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