Department of Endocrinology, Radboud University Nijmegen Medical Centre, HB Nijmegen, The Netherlands.
Eur J Endocrinol. 2012 Dec 10;168(1):91-9. doi: 10.1530/EJE-12-0404. Print 2013 Jan.
Short stature is a prominent feature of Turner syndrome (TS), which is partially overcome by GH treatment. We have previously reported the results of a trial on the effect of oxandrolone (Ox) in girls with TS. Ox in a dose of 0.03 mg/kg per day (Ox 0.03) significantly increased adult height gain, whereas Ox mg/kg per day (0.06) did not, at the cost of deceleration of breast development and mild virilization. The aim of this follow-up study in adult participants of the pediatric trial was to investigate the long-term effects of previous Ox treatment.
During the previous randomized controlled trial, 133 girls were treated with GH combined with placebo (Pl), Ox 0.03, or Ox 0.06 from 8 years of age and estrogen from 12 years. Sixty-eight women (Pl, n=23; Ox 0.03, n=27; and Ox 0.06, n=18) participated in the double-blind follow-up study (mean age, 24.0 years; mean time since stopping GH, 8.7 years; and mean time of Ox/Pl use, 4.9 years). We assessed height, body proportions, breast size, virilization, and body composition.
Height gain (final minus predicted adult height) was maintained at follow-up (Ox 0.03 10.2±4.9 cm, Ox 0.06 9.7±4.4 cm vs Pl 8.0±4.6 cm). Breast size, Tanner breast stage, and body composition were not different between groups. Ox-treated women reported more subjective virilization and had a lower voice frequency.
Ox 0.03 mg/kg per day has a beneficial effect on adult height gain in TS patients. Despite previously reported deceleration of breast development during Ox 0.03 treatment, adult breast size is not affected. Mild virilization persists in only a small minority of patients. The long-term evaluation indicates that Ox 0.03 treatment is effective and safe.
身材矮小是特纳综合征(TS)的一个显著特征,生长激素(GH)治疗可部分改善这一特征。我们之前报道过一项关于奥氮酮(Ox)治疗 TS 女孩的疗效的试验结果。Ox 的剂量为 0.03mg/kg/天(Ox 0.03)可显著增加成年身高增长,而 Ox 0.06mg/kg/天(0.06)则不能,同时还会导致乳房发育减速和轻度男性化。本研究是对儿科试验中成年参与者的后续研究,旨在探讨之前 Ox 治疗的长期效果。
在之前的随机对照试验中,133 名女孩从 8 岁起接受 GH 联合安慰剂(Pl)、Ox 0.03 或 Ox 0.06 治疗,12 岁起接受雌激素治疗。68 名女性(Pl,n=23;Ox 0.03,n=27;Ox 0.06,n=18)参加了这项双盲随访研究(平均年龄 24.0 岁;停止 GH 治疗后平均时间 8.7 年;Ox/Pl 治疗平均时间 4.9 年)。我们评估了身高、身体比例、乳房大小、男性化和身体成分。
身高增长(最终身高减去预测成年身高)在随访时得到维持(Ox 0.03 为 10.2±4.9cm,Ox 0.06 为 9.7±4.4cm,Pl 为 8.0±4.6cm)。各组之间乳房大小、Tanner 乳房分期和身体成分无差异。Ox 治疗的女性报告更多的主观男性化,并且声音频率更低。
Ox 0.03mg/kg/天对 TS 患者的成年身高增长有有益的影响。尽管之前报道 Ox 0.03 治疗期间乳房发育减速,但成年乳房大小不受影响。仅有一小部分患者存在轻微男性化。长期评估表明 Ox 0.03 治疗是有效和安全的。