Height gain in Ullrich-Turner syndrome after early and late growth hormone treatment start: results from a large retrospective German study and potential basis for an individualized treatment approach.
BACKGROUND
Ullrich-Turner syndrome (UTS) girls often present with short stature in adolescence to the endocrinologist when the efficacy of growth hormone (GH) to improve growth remains unknown and parameters to estimate individual GH responsiveness have yet to be determined.


OBJECTIVE
Retrospective evaluation of adult height (AH) and predicted adult height at GH start (descriptive model of Ranke, Model PredAH) in early and late GH-treated German UTS patients.


METHODS
313 patients treated with GH, early [chronological age (CA) at GH start <12 years, n = 259] or late (CA at GH start ≥12 years, n = 54) who reached AH were selected from KIGS (Pfizer International Growth Database).


RESULTS
AH (152.5 ± 5.9 vs. 151.1 ± 5.4 cm, p = n.s.) after GH treatment for 7.5 ± 2.12 years (GH start early) and for 5.2 ± 1.2 years (GH start late) were similar (p = n.s.) as Model PredAH (155.7 ± 4.8 vs. 154.7 ± 4.8 cm; p = n.s.) but higher (p < 0.001) than projected adult height (Ranke, ProjAH; 148.2 ± 5.5 vs. 145.2 ± 6.7 cm; p = 0.001). Total height gain over ProjAH was 4.3 ± 4.6 cm (GH start early) and 5.8 ± 4.7 cm (GH start late, p = 0.021), respectively.


CONCLUSIONS
GH may improve AH in UTS patients even when started late. The individual growth response could be estimated by the descriptive Model PredAH independent of age at treatment start.
Hospital for Children and Adolescents, University of Heidelberg, Heidelberg, Germany.
Markus
M
Bettendorf
Ioana M
IM
Inta
Helmuth G
HG
Doerr
Berthold P
BP
Hauffa
Otto
O
Mehls
Michael B
MB
Ranke
D000293:Adolescent; D000367:Age Factors; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D012189:Retrospective Studies; D014424:Turner Syndrome / Q000188:drug therapy* / Q000503:physiopathology*
D019382:Human Growth Hormone