Dacou-Voutetakis C, Karavanaki-Karanassiou K, Petrou V, Georgopoulos N, Maniati-Christidi M, Mavrou A
First Pediatric Department, Athens University, Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.
Pediatrics. 1998 Apr;101(4 Pt 1):663-8. doi: 10.1542/peds.101.4.663.
Shortness is the most frequent and quite disturbing characteristic of girls with Turner syndrome (TS). Human growth hormone administration (hGH) to girls with TS increases growth velocity (GV), but a favorable effect on final height (FH) has not been documented. The aim of this study was to evaluate the effect of hGH administration on the growth pattern and FH in girls with TS.
The study group was comprised of 123 girls with TS who were cared for in our center. Eighty-two of these girls received hGH (mean dose, 0.78 +/- 0.12 IU/kg/week), given subcutaneously 5 to 7 times per week for a period of 2.2 +/- 1.2 years (hGH group). The mean chronological age (CA) and bone age (BA) at hGH initiation were 11.5 +/- 2.5 years and 9.7 +/- 2.3 years, respectively. The remaining 41 girls did not receive hGH and are designated as the untreated control group. In both groups, gonadal steroids were given for pubertal initiation and maintenance.
The GV during the first year of hGH therapy (GV1) was higher than the year before hGH (6.3 cm/year vs 4.0 cm/year) and higher than the GV of the untreated group at a similar CA (4.4 cm/year). The GVs during the second (GV2) and third (GV3) year of hGH treatment (5.4 and 4.9 cm/year, respectively) were lower, but still higher in the hGH group, in comparison with the untreated group (GV2, 4.2 cm/year; GV3, 3.4 cm/year). GV1, GV2, and GV3 were negatively related to age and to BA at hGH initiation. The FH of the 35 hGH-treated girls was not significantly different from the FH of the 27 untreated girls (146.1 cm vs 144.0 cm). The Delta target height-FH was not significantly different in the two groups. The FH standard deviation score of the hGH-treated group was positively related to height standard deviation score for CA at treatment initiation (r = +0.73), maternal height (r = +0.57), target height (r = + 0.66), and birth weight (r = +0.54), but was unrelated to CA or BA at start of therapy or to hGH dose.
hGH therapy in girls with TS, in the dose and duration of treatment applied in this study, significantly accelerated GV but did not significantly improve FH.
身材矮小是特纳综合征（TS）女孩最常见且相当令人困扰的特征。对TS女孩使用人生长激素（hGH）可提高生长速度（GV），但对最终身高（FH）的有利影响尚无文献记载。本研究的目的是评估hGH治疗对TS女孩生长模式和FH的影响。
研究组由在我们中心接受治疗的123例TS女孩组成。其中82例女孩接受hGH治疗（平均剂量，0.78±0.12 IU/kg/周），每周皮下注射5至7次，持续2.2±1.2年（hGH组）。开始使用hGH时的平均实际年龄（CA）和骨龄（BA）分别为11.5±2.5岁和9.7±2.3岁。其余41例女孩未接受hGH治疗，被指定为未治疗对照组。两组均给予性腺类固醇以启动和维持青春期。
hGH治疗第一年的生长速度（GV1）高于使用hGH前一年（6.3厘米/年对4.0厘米/年），且高于未治疗组在相似CA时的生长速度（4.4厘米/年）。hGH治疗第二年（GV2）和第三年（GV3）的生长速度（分别为5.4和4.9厘米/年）较低，但与未治疗组相比，hGH组仍较高（GV2，4.2厘米/年；GV3，3.4厘米/年）。GV1、GV2和GV3与开始使用hGH时的年龄和BA呈负相关。35例接受hGH治疗女孩的FH与27例未治疗女孩的FH无显著差异（146.1厘米对144.0厘米）。两组的目标身高-FH差值无显著差异。hGH治疗组的FH标准差评分与开始治疗时CA的身高标准差评分（r = +0.73）、母亲身高（r = +0.57）、目标身高（r = +0.66）和出生体重（r = +0.54）呈正相关，但与治疗开始时的CA或BA以及hGH剂量无关。
在本研究应用的剂量和疗程下，对TS女孩进行hGH治疗可显著加快生长速度，但未显著改善最终身高。
