title: Analyses from a centre of short- and long-term growth in Turner's syndrome on standard growth hormone doses confirm growth prediction algorithms and show normal IGF-I levels.
abstract: OBJECTIVE
  Prediction algorithms suggest factors determining short- and long-term growth response to growth hormone (GH) in Turner's syndrome (TS). A total of 133 patients (group A; 53% with karyotype 45,X) completed 1 year of treatment and 77 patients (group B) reached adult height (AH) after >4 years on GH treatment. The patients were analysed for factors determining the outcomes, and in addition, the validity of published algorithms was tested.
  
  
  RESULTS
  In group A [values are given as medians (10th-90th percentiles)], starting age was 9.4 (4.8-14) years, height was -3.2 (-4.4 to -1.9) SDS (Prader references), and GH dose was 38 (23-48) μg/kg/day. Observed height velocity was 7.7 (5.2-9.8) cm/years and was equal to the predicted height velocity. In group B, projected adult height (PAH) was 147.4 (139.5-154.8) cm. Total gain in height over PAH of 6.1 (2.0-12.6) cm was negatively correlated with height at start, but positively correlated with GH duration, first year Δheight SDS, or index of responsiveness. Observed AH was 153.5 (146.6-160.1) cm and predicted AH was 155.0 (147.4-161.0) cm, which is statistically not different. On GH <5% IGF-I levels were >2 SDS.
  
  
  CONCLUSIONS
  The published prediction algorithms were found to be valid. If normal AH is to be reached at the lowest costs and risks, probably only TS children with a good growth potential and a high responsiveness to GH can be treated successfully with GH doses of <50 μg/kg/day.
authors.affiliation: Paediatric Endocrinology and Diabetology, University Children's Hospital, Tuebingen, Germany. Michael.Ranke@gmx.de
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ranke
authors.forename: Roland
authors.initials: R
authors.lastname: Schweizer
authors.forename: David D
authors.initials: DD
authors.lastname: Martin
authors.forename: Stefan
authors.initials: S
authors.lastname: Ehehalt
authors.forename: Carl-Philipp
authors.initials: CP
authors.lastname: Schwarze
authors.forename: Felice
authors.initials: F
authors.lastname: Serra
authors.forename: Gerhard
authors.initials: G
authors.lastname: Binder
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects*; D000465:Algorithms; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D015331:Cohort Studies; D004351:Drug Resistance; D005260:Female; D005858:Germany; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D014424:Turner Syndrome / Q000097:blood* / Q000188:drug therapy*
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I