Van den Broeck J, Massa G G, Attanasio A, Matranga A, Chaussain J L, Price D A, Aarskog D, Wit J M
Bureau of the Dutch Growth Foundation, University Hospital Leiden, The Netherlands.
J Pediatr. 1995 Nov;127(5):729-35. doi: 10.1016/s0022-3476(95)70161-3.
To study final height after long-term growth hormone (GH) treatment in girls with Turner syndrome (TS).
One hundred fifty three patients with TS, participating in five European trials, were included. They started GH treatment in 1987-1989 at an age of 10 years or older. Mean age at start of treatment ranged between 11.7 and 14.6 years among countries and mean bone age between 9.4 and 11.8 years. Fourteen girls were lost to follow-up, leaving 139 for analysis. Most girls have now attained final height (FH), defined as a linear growth velocity (GV) of 4 mm/yr or less, measured over at least 6 months (group 1, n = 56), or near-FH, defined as a GV of 5 to 9 mm/yr (group 2, n = 22). Sixty-one girls were still growing 10 mm/yr or more.
At the last measurement, mean (SD) height was 150.7 (4.9) cm in group 1 and 148.5 (5.1) cm in group 2. The differences between FH and projected final height based on extrapolation of the initial height-standard deviation score on Turner syndrome reference values, were 2.9 (3.8) and 3.0 (3.3) cm, respectively. The mean gain over the Bayley-Pinneau prediction of FH was 3.3 (3.9) cm in both groups. No significant differences between countries were found. The range of gains over projected height (-4.7 to 12.1 cm) was large, and 25% of gains were 5 cm or more. Gain over initial projection was strongly related to initial growth delay and to growth response during the first 2 years of treatment. A logistic regression model is presented that predicts gain of more than 5 cm with a positive predictive value of 62% and a negative predictive value of 84%.
Long-term GH treatment in girls with TS, starting treatment at a relatively advanced age ( > 10 years) resulted in a modest mean gain in FH of 3 cm, with wide interindividual variation.
研究特纳综合征（TS）女孩长期生长激素（GH）治疗后的最终身高。
纳入了参与五项欧洲试验的153例TS患者。她们于1987 - 1989年开始GH治疗，年龄在10岁及以上。各国开始治疗时的平均年龄在11.7至14.6岁之间，平均骨龄在9.4至11.8岁之间。14名女孩失访，剩余139名用于分析。大多数女孩现已达到最终身高（FH），定义为至少6个月内线性生长速度（GV）为4毫米/年或更低（第1组，n = 56），或接近最终身高，定义为GV为5至9毫米/年（第2组，n = 22）。61名女孩的生长速度仍为10毫米/年或更快。
在最后一次测量时，第1组的平均（标准差）身高为150.7（4.9）厘米，第2组为148.5（5.1）厘米。根据特纳综合征参考值对初始身高标准差分数进行外推得出的最终身高与预测最终身高之间的差异分别为2.9（3.8）厘米和3.0（3.3）厘米。两组相对于贝利 - 平诺预测的最终身高的平均增长均为3.3（3.9）厘米。未发现各国之间存在显著差异。相对于预测身高的增长范围（-4.7至12.1厘米）较大，25%的增长为5厘米或更多。相对于初始预测的增长与初始生长延迟以及治疗前两年的生长反应密切相关。提出了一个逻辑回归模型，该模型预测增长超过5厘米，阳性预测值为62%，阴性预测值为84%。
TS女孩在相对较高年龄（>10岁）开始长期GH治疗，最终身高平均适度增长3厘米，个体间差异较大。
