12283
document
Final height in girls with turner syndrome after long-term growth hormone treatment in three dosages and low dose estrogens . Although GH treatment for short stature in Turner syndrome is an accepted treatment in many countries , which GH dosage to use and which age to start puberty induction are issues of debate . This study shows final height ( FH ) in 60 girls with Turner syndrome treated in a randomized dose-response trial , combining GH treatment with low dose estrogens at a relatively young age . Girls were randomly assigned to group A ( 4 IU/m ( 2 ) .d ; approximately 0.045 mg/kg/d ) , group B ( first year , 4 IU/m ( 2 ) .d ; thereafter 6 IU/m ( 2 ) .d ) , or group C ( first year , 4 IU/m ( 2 ) .d ; second year , 6 IU/m ( 2 ) .d ; thereafter , 8 IU/m ( 2 ) .d ) . After a minimum of 4 yr of GH treatment , at a mean age of 12.7 +/- 0.7 yr , low dose micronized 17beta-estradiol was given orally . After a mean duration of GH treatment of 8.6 +/- 1.9 yr , FH was reached at a mean age of 15.8 +/- 0.9 yr. FH , expressed in centimeters or SD score , was 157.6 +/- 6.5 or -1.6 +/- 1.0 in group A , 162.9 +/- 6.1 or -0.7 +/- 1.0 in group B , and 163.6 +/- 6.0 or -0.6 +/- 1.0 in group C. The difference in FH in centimeters , corrected for height SD score and age at start of treatment , was significant between groups A and B [ regression coefficient , 4.1 ; 95 % confidence interval ( CI ) , 1.4 , 6.9 ; P < 0.01 ] , and groups A and C ( coefficient , 5.0 ; 95 % CI , 2.3 , 7.7 ; P < 0.001 ) , but not between groups B and C ( coefficient , 0.9 ; 95 % CI , -1.8 , 3.6 ) . Fifty of the 60 girls ( 83 % ) had reached a normal FH ( FH SD score , more than -2 ) . After starting estrogen treatment , the decrease in height velocity ( HV ) changed significantly to a stable HV , without affecting bone maturation ( change in bone age/change in chronological age ) . The following variables contributed significantly to predicting FH SD score : GH dose , height SD score ( ref . normal girls ) , chronological age at start of treatment , and HV in the first year of GH treatment . GH treatment was well tolerated . In conclusion , GH treatment leads to a normalization of FH in most girls , even when puberty is induced at a normal pubertal age . The optimal GH dosage depends on height and age at the start of treatment and first year HV .
12284
Intervention_Pharmacological
estrogens
12285
Intervention_Pharmacological
GH treatment
12286
Intervention_Pharmacological
combining GH treatment with low dose estrogens
12287
Intervention_Pharmacological
GH treatment
12288
Intervention_Pharmacological
micronized 17beta-estradiol
12289
Intervention_Pharmacological
GH
12290
Intervention_Pharmacological
estrogen
12291
Intervention_Pharmacological
GH
12292
Intervention_Pharmacological
GH
12293
Intervention_Pharmacological
GH
12294
Outcome_Physical
Final height in girls
12295
Outcome_Physical
final height ( FH )
12296
Outcome_Other
duration of GH treatment
12297
Outcome_Physical
FH
12298
Outcome_Physical
FH in centimeters
12299
Outcome_Physical
normal FH
12300
Outcome_Other
decrease in height velocity ( HV ) changed significantly to a stable HV
12301
Outcome_Physical
bone maturation
12302
Outcome_Physical
FH SD score
12303
Outcome_Physical
GH dose
12304
Outcome_Physical
height SD score
12305
Outcome_Physical
HV
12306
Outcome_Other
well tolerated
12307
Outcome_Physical
FH
12308
Participant_Sex
girls
12309
Participant_Condition
turner syndrome
12310
Participant_Sample-size
60
12311
Participant_Sex
girls
12312
Participant_Condition
Turner syndrome
12313
Participant_Sex
Girls
12314
Participant_Sample-size
Fifty
12315
Participant_Sample-size
60
12316
Participant_Sex
girls