School of Life Sciences, Tsinghua University, Beijing, China.
Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, The Translational Medicine Center of PUMCH, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
J Pediatr Endocrinol Metab. 2021 Mar 4;34(4):465-471. doi: 10.1515/jpem-2020-0610. Print 2021 Apr 27.
Short stature and thyroid autoimmunity are common comorbidities in Turner syndrome (TS). Recombinant human growth hormone (rhGH) significantly improves height growth in TS individuals. This study aims to investigate the association of thyroid autoimmunity and the response to rhGH treatment in TS patients.
Medical records of 494 patients with TS were reviewed. Among 126 patients who regularly tested for thyroid autoantibodies, 108 patients had received rhGH treatment. Clinical characteristics, including karyotype and the presence of autoimmune thyroid diseases, as well as rhGH treatment records were analyzed. Height velocity (HV) of patients with or without thyroid autoimmunity was compared to assess the response to rhGH treatment. For patients who developed thyroid autoantibodies during rhGH treatment, HV before and after antibody presence were compared.
45XO monosomy presented in 36% (176/496) of patients. 42.1% of patients (53/126) had elevated circulating anti-thyroid peroxidase antibody and anti-thyroglobulin antibody. In 108 patients who received rhGH treatment, HVs were significantly correlated to age, height, weight and BMI at the initiation of treatment. For patients who developed thyroid autoantibodies during rhGH treatment, HVs after thyroid autoantibody presence significantly decreased compared with HVs before thyroid autoantibody detection (n=44, p=0.0017).
Our data suggested that in TS patients who developed thyroid autoantibodies during rhGH treatment, the response to rhGH is negatively associated with the development of thyroid autoimmunity.
身材矮小和甲状腺自身免疫是 Turner 综合征（TS）的常见合并症。重组人生长激素（rhGH）可显著改善 TS 个体的身高增长。本研究旨在探讨甲状腺自身免疫与 TS 患者对 rhGH 治疗反应的关系。
回顾了 494 例 TS 患者的病历。在 126 例定期检测甲状腺自身抗体的患者中，有 108 例接受了 rhGH 治疗。分析了临床特征，包括核型和自身免疫性甲状腺疾病的存在，以及 rhGH 治疗记录。比较有或无甲状腺自身免疫的患者的身高增长率（HV），以评估对 rhGH 治疗的反应。对于在 rhGH 治疗期间发生甲状腺自身抗体的患者，比较抗体出现前后的 HV。
45XO 单体性在 36%（176/496）的患者中出现。42.1%的患者（53/126）存在循环抗甲状腺过氧化物酶抗体和抗甲状腺球蛋白抗体升高。在 108 例接受 rhGH 治疗的患者中，HV 与治疗开始时的年龄、身高、体重和 BMI 显著相关。对于在 rhGH 治疗期间发生甲状腺自身抗体的患者，与甲状腺自身抗体检测前相比，甲状腺自身抗体出现后的 HV 显著下降（n=44，p=0.0017）。
我们的数据表明，在 rhGH 治疗期间发生甲状腺自身抗体的 TS 患者中，rhGH 的反应与甲状腺自身免疫的发展呈负相关。
