Major determinants of height development in Turner syndrome (TS) patients treated with GH: analysis of 987 patients from KIGS.
Little is known about factors determining height outcome during GH treatment in Turner syndrome (TS). We investigated 987 TS children within the Kabi International Growth Study (KIGS) who had reached near adult height (NAH) after >4 y GH treatment (including >1 y before puberty). Through multiple regression analysis we developed a model for NAH and total gain. Our results were as follows (median): 1) At start, age 9.7 yrs, height (HT) 118.0 cm (0.0 TS SDS), projected adult height 146.1 cm, GH dose 0.27 mg/kg wk; 2) NAH HT 151.0 cm (1.5 TS SDS); 3) Prepubertal gain 21.2 cm (1.6 TS SDS); 4) Pubertal gain 9.4 cm (0.0 TS SDS). NAH correlated (r = 0.67) with (ranked) HT at GH start (+), 1 year responsiveness to GH (+), MPH (+), age at puberty onset (+), age at GH start (-), and dose (+). The same factors explained (R = 0.90) the total HT gain. However, HT at GH start correlated negatively. Karyotype had no influence on outcome. Evidently, height at GH start (the taller, the better), age at GH start (the younger, the better), the responsiveness to GH (the higher, the better) and age at puberty (the later, the better) determine NAH.
Ranke
Michael B
MB
Paediatric Endocrinology Section, Children's Hospital, University of Tuebingen, D-72076 Tuebingen, Germany. Michael.Ranke@med.uni-tuebingen.de
Lindberg
Anders
A
Ferrández Longás
Angel
A
Darendeliler
Feyza
F
Albertsson-Wikland
Kerstin
K
Dunger
David
D
Cutfield
Wayne S
WS
Tauber
Maïthé
M
Wilton
Patrick
P
Wollmann
Hartmut A
HA
Reiter
Edward O
EO
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D002648:Child; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D014424:Turner Syndrome / Q000188:drug therapy*
D019382:Human Growth Hormone