ISSN:1663-2818    

DOI:10.1159/000182757

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The aims of this national multicentre study in Finland were to evaluate whether the height velocity of patients with Turner syndrome would increase with the conventional human growth hormone (GH) therapy regimen normally given to GH-deficient children and whether girls with Turner syndrome actually show GH neurosecretory dysfunction. Finally, the study should show whether GH therapy improves height prognosis and, eventually, final height. Twenty-five girls with Turner syndrome, aged 7.5-14.4 years, entered the study. Their ability to secrete GH was determined and, surprisingly, several would have been classified as having GH deficiency. All girls received GH, 0.1 IU/kg/day (maximum dose 4 IU/day) s.c, and once over 12.5 years old, they also received oestradiol valerate and fluoxymesterone. They showed a convincing increase in height velocity, and rapid growth continued during the second year of therapy. The effect of GH therapy on final height is still unknown. The therapy was remarkably free of side-effects.

ISSN:1663-2818    

DOI:10.1159/000182758

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The effects of treatment with human growth hormone (GH) for 2 years, followed by combined treatment with GH and oestradiol valerate, were studied in girls with Turner syndrome, aged 7.0-16.6 years. Height SDS (Turner standards) increased after GH treatment, and height velocity SDS (Turner standards) increased dramatically 6 months after the start of GH treatment and gradually declined after 2 years’ treatment. A further increase occurred after 18 months of GH and oestradiol treatment in conjunction with the pubertal growth spurt, followed by a decline 6 months later. Height SDS for bone age increased during GH treatment, and remained virtually unchanged after the introduction of oestradiol. Predicted final height increased after the first year of GH treatment only. The use of GH and oestrogen treatment in Turner syndrome is discussed in the light of these preliminary result

ISSN:1663-2818    

DOI:10.1159/000182759

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Early studies on the use of human growth hormone (hGH) for the treatment of Turner syndrome are reviewed and attention is drawn to the higher dose used compared with the doses for growth hormone deficiency (GHD). Patients with Turner syndrome responded less consistently than GHD patients to hGH. The prediction of final height in Turner syndrome from bone age is uncertain – long-term trials are essential to resolve final height questions. The pros and cons of randomized placebo-controlled trials, randomized nontreatment-controlled trials and historical controlled trials are compared, and it is concluded that in the USA, a randomized placebo-controlled trial is the most appropriate study design. The ethical considerations of such a long-term trial, in terms of risk vs. benefit, and the need for a placebo-treated group are also discusse

ISSN:1663-2818    

DOI:10.1159/000182761

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000182762

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Recombinant human growth hormone (GH) is effective in promoting growth velocity in subjects with Turner syndrome. As higher doses are used for this indication than for substitution therapy in GH deficiency, the long-term effects of GH therapy on carbohydrate metabolism represent a safety issue; this is particularly important in Turner syndrome, in which there is an increased prevalence of impaired glucose tolerance. So far, GH therapy has been given to patients with Turner syndrome for up to 7 years without any significant changes having been reported in glycosylated haemoglobin (HbA1c) values, unstimulated and stimulated oral glucose tolerance test (OGTT) blood glucose and serum insulin concentrations. These findings may, however, be influenced by other variables, such as study design, number of subjects or standardization methods applied. Results of an ongoing trial in the FRG, from which 2 years’ data on glucose metabolism (as assessed by serial OGTTs) of 72 patients with Turner syndrome are available, indicate that glucose homoeostasis is maintained at the expense of an increase in insulin secretion, which is time- and dose-dependent. Although these changes may be fully reversible on withdrawal of GH. therapy, accurate control of glucose metabolism both during and after GH. treatment is advocate

ISSN:1663-2818    

DOI:10.1159/000182763

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000182764

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Girls with Turner syndrome were divided according to age (group A 6-12 years, and group B 12-19 years) and human growth hormone (GH) dose regimen (Al and Bl, three injections/week; A2 and B2, six injections/week). All groups responded to GH, 24 IU/m2/week, with an increase in height velocity, though in the older girls, the response was comparatively poor. Therefore, the dose regimens in groups B1 and B2 were increased to 36 IU/m2/week given as six injections in both groups. This change resulted in an increase in height velocity only in group B1. During the first 2 years only, the height velocity was greater in group A2 than group A1. The conclusion is that a regimen of six injections/week is more effective than one of three injections/week in terms of initial height gain and change in predicted adult height. In girls with Turner syndrome aged over 16 years, GH therapy has no significant effect.

ISSN:1663-2818    

DOI:10.1159/000182765

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Patients with Turner syndrome were treated with recombinant human growth hormone (GH) for 3 years. Sixty-eight patients received GH, 0.5 IU/kg/week, while 93 received GH, 1.0 IU/kg/week, by daily subcutaneous injection. Both treatment groups showed a statistically significant increase in growth during treatment. However, the higher dose increased height velocity to a significantly greater extent during the first and second year of treatment. The projected adult height was exceeded by 52 of 71 patients over the age of 14 years. Plasma insulin-like growth factor 1 levels were elevated and no remarkable advances in bone age were observed. There were no other significant changes in physical or laboratory parameters. No glucose intolerance was observed. These results indicate that GH treatment is useful for accelerating growth velocity in patients with Turner syndrome. However, further study will be required to find the most appropriate dose.

ISSN:1663-2818    

DOI:10.1159/000182766

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:1663-2818    

DOI:10.1159/000182767

出版商:S. Karger AG    

年代:1993

数据来源: Karger