Morin Analia, Guimarey Luis M, Apezteguia Maria, Santucci Zulma C
Sala de Endocrinología, Hospital de Niños Sor María Ludovica, La Plata.
Medicina (B Aires). 2009;69(4):431-6.
We studied the adult height (AH) outcome, and factors likely to influence it, in Turner Syndrome (TS) girls treated with growth hormone (GH). A total of 25 TS girls treated with GH were compared with 10 TS girls not treated with GH. The percentage of girls who achieved normal third percentile was determined. Projected AH (PAH) was calculated according to height standard deviation score (HSDS) at the beginning of the treatment. Gain in height was determined as: AH - pretreatment PAH. The percentage of girls who achieved target range (midparental height +/- 2 SD) was determined. Multiple linear regression models were fitted on baseline variables- chronological age (CA), midparental height (MPH) and HSDS; and treatment variables- duration of oestrogen-free GH therapy and duration of GH therapy+oestrogens. As for baseline data: Median CA was 13.0 years (5.6-15.8). Mean HSDS was 0.25 +/- 1.1 SDS. PAH was 139.2 +/- 5.6 cm. MPH was 160.0 +/- 5.0 cm. As for follow up data: Median CA at onset oestrogens was 15.1 years (13.2-16.6). Median duration of GH therapy was 3.8 years (2.1-10.3). Median oestrogen-free GH period was 2.0 years (0.7-7.8), and median GH+oestrogens period, 1.8 years (1.0-3.2). Adult height: Mean AH was 150.4 +/- 7.0 cm in treated patients and 140.8 +/- 7.2 cm in the group not treated with GH (p=0.001). Fourteen (56%) girls achieved normal third percentile compared with an initially predicted 1 (4%). Gain in height was 11.2 +/- 3.7 cm. Thirteen (59%) girls reached an AH within target range. HSDS at the beginning of the treatment was the variable most strongly related to AH and duration of oestrogen-free GH period was the variable most strongly related to gain in height.
我们研究了接受生长激素(GH)治疗的特纳综合征(TS)女孩的成人身高(AH)结果及其可能的影响因素。将总共25名接受GH治疗的TS女孩与10名未接受GH治疗的TS女孩进行比较。确定达到正常第三百分位数的女孩百分比。根据治疗开始时的身高标准差评分(HSDS)计算预计成人身高(PAH)。身高增加量的计算方法为:AH - 治疗前PAH。确定达到目标范围(父母平均身高±2标准差)的女孩百分比。对基线变量——实足年龄(CA)、父母平均身高(MPH)和HSDS;以及治疗变量——无雌激素GH治疗持续时间和GH + 雌激素治疗持续时间,拟合多元线性回归模型。关于基线数据:CA中位数为13.0岁(5.6 - 15.8岁)。平均HSDS为0.25 ± 1.1 SDS。PAH为139.2 ± 5.6厘米。MPH为160.0 ± 5.0厘米。关于随访数据:开始使用雌激素时的CA中位数为15.1岁(13.2 - 16.6岁)。GH治疗的中位数持续时间为3.8年(2.1 - 10.3年)。无雌激素GH治疗期的中位数为2.0年(0.7 - 7.8年),GH + 雌激素治疗期的中位数为1.8年(1.0 - 3.2年)。成人身高:接受治疗的患者平均AH为150.4 ± 7.0厘米,未接受GH治疗组为140.8 ± 7.2厘米(p = 0.001)。14名(56%)女孩达到正常第三百分位数,而最初预测只有1名(4%)。身高增加量为11.2 ± 3.7厘米。13名(59%)女孩的AH在目标范围内。治疗开始时的HSDS是与AH最密切相关的变量,无雌激素GH治疗期的持续时间是与身高增加量最密切相关的变量。