Department of Pediatric Endocrinology, College of Medicine, Gachon University, Seoul, Republic of Korea,
Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Horm Res Paediatr. 2019;91(6):373-379. doi: 10.1159/000500780. Epub 2019 Sep 3.
This study aimed to evaluate final adult height (AH) after recombinant human growth hormone (GH) treatment of girls with Turner syndrome (TS) and to elucidate the predicting factors for their growth response.
We enrolled 73 patients with TS who underwent GH treatment and reached AH and 14 patients who did not undergo treatment. To assess the effectiveness of GH therapy, we evaluated final AH, height gain over the predicted AH, and height gain over the projected AH. In addition, to analyze the factors affecting final AH, we studied correlations between final AH (or height SDS, height gain) and treatment variables.
GH therapy was started at a mean age of 8.87 ± 3.73 years, and the treatment duration was 6.47 ± 3.02 years. The patients in the treated group reached a final AH of 152.03 ± 4.66 cm (final AH SDS for the general population: -1.93 ± 1.03) with a gain over projected AH at the start of treatment of 12.21 ± 4.33 cm. The untreated control subjects had a final AH of 143.57 ± 4.06 cm with a gain over projected AH at the first visit of 3.89 ± 3.80 cm. Final AH and AH SDS were positively correlated to height SDS at the start of treatment. Thirty-five patients out of the 73 GH-treated patients (47.9%) attained to a normal range of height for Korean girls. The patients having attained to a normal height range after GH treatment had shown a higher height SDS at the start of GH treatment, a higher mid-parental height SDS, and a younger age at initiation of estrogen.
Our findings demonstrate that GH treatment at an early age is effective in improving the final height SDS and height SDS gain in TS patients. Therefore, GH administration at an early age is important for final height gain.
本研究旨在评估特纳综合征（TS）女孩接受重组人生长激素（GH）治疗后的最终成人身高（AH），并阐明其生长反应的预测因素。
我们纳入了 73 名接受 GH 治疗并达到 AH 的 TS 患者和 14 名未接受治疗的患者。为了评估 GH 治疗的有效性，我们评估了最终 AH、预测 AH 以上的身高增长和预测 AH 以上的身高增长。此外，为了分析影响最终 AH 的因素，我们研究了最终 AH（或身高 SDS、身高增长）与治疗变量之间的相关性。
GH 治疗开始于平均年龄 8.87 ± 3.73 岁，治疗持续时间为 6.47 ± 3.02 年。治疗组患者达到最终 AH 为 152.03 ± 4.66cm（普通人群最终 AH SDS：-1.93 ± 1.03），治疗开始时预测 AH 以上的身高增长为 12.21 ± 4.33cm。未接受治疗的对照组患者最终 AH 为 143.57 ± 4.06cm，首次就诊时预测 AH 以上的身高增长为 3.89 ± 3.80cm。最终 AH 和 AH SDS 与治疗开始时的身高 SDS 呈正相关。在 73 名接受 GH 治疗的患者中，有 35 名（47.9%）达到了韩国女孩正常身高范围。接受 GH 治疗后达到正常身高范围的患者在开始 GH 治疗时身高 SDS 更高，中亲身高 SDS 更高，雌激素起始年龄更年轻。
我们的研究结果表明，在早期给予 GH 治疗可有效改善 TS 患者的最终身高 SDS 和身高 SDS 增长。因此，早期给予 GH 治疗对最终身高增长很重要。
