title: Growth hormone positive effects on craniofacial complex in Turner syndrome.
abstract: OBJECTIVE
  Turner syndrome occurs in phenotypic females with complete or partial absence of X chromosome. The leading symptom is short stature, while numerous but mild stigmata manifest in the craniofacial region. These patients are commonly treated with growth hormone to improve their final height. The aim of this study was to assess the influence of long-term growth hormone therapy on craniofacial morphology in Turner syndrome patients.
  
  
  METHODS
  In this cross-sectional study cephalometric analysis was performed on 13 lateral cephalograms of patients with 45,X karyotype and the average age of 17.3 years, who have received growth hormone for at least two years. The control group consisted of 13 Turner syndrome patients naive to growth hormone treatment, matched to study group by age and karyotype. Sixteen linear and angular measurements were obtained from standard lateral cephalograms. Standard deviation scores were calculated in order to evaluate influence of growth hormone therapy on craniofacial components.
  
  
  RESULTS
  In Turner syndrome patients treated with growth hormone most of linear measurements were significantly larger compared to untreated patients. Growth hormone therapy mainly influenced posterior face height, mandibular ramus height, total mandibular length, anterior face height and maxillary length. While the increase in linear measurements was evident, angular measurements and facial height ratio did not show statistically significant difference. Acromegalic features were not found.
  
  
  CONCLUSIONS
  Long-term growth hormone therapy has positive influence on craniofacial development in Turner syndrome patients, with the greatest impact on posterior facial height and mandibular ramus. However, it could not compensate X chromosome deficiency and normalize craniofacial features.
authors.affiliation: Department of Orthodontics, School of Dental Medicine, University of Belgrade, Gastona Gravijea 2, 11000 Belgrade, Serbia. Electronic address: juloski.jovana@gmail.com.
authors.forename: Jovana
authors.initials: J
authors.lastname: Juloski
authors.affiliation: Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia; Department of Dental Medicine, University Hospital Center Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia. Electronic address: dumancic@sfzg.hr.
authors.forename: Jelena
authors.initials: J
authors.lastname: Dumančić
authors.affiliation: Department of Orthodontics, School of Dental Medicine, University of Belgrade, Gastona Gravijea 2, 11000 Belgrade, Serbia. Electronic address: ivana.scepan@stomf.bg.ac.rs.
authors.forename: Ivana
authors.initials: I
authors.lastname: Šćepan
authors.affiliation: Department of Anthropology, Faculty of Social Sciences and Humanities, University of Zagreb, Ivana Lučića 3, 10000 Zagreb, Croatia,; Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia. Electronic address: tomislav.lauc@gmail.com.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Lauc
authors.affiliation: Institute of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Dr. Subotića 1, 11000 Belgrade, Serbia. Electronic address: jelena.milasin@stomf.bg.ac.rs.
authors.forename: Jelena
authors.initials: J
authors.lastname: Milašin
authors.affiliation: Croatian Dental Chamber, Kurelčeva 3, 10000 Zagreb, Croatia; Croatian Academy of Medical Sciences, Praška 2, 10000 Zagreb, Croatia. Electronic address: kaiczvonimir@gmail.com.
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Kaić
authors.affiliation: Medical Faculty, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia. Electronic address: drdumic@mef.hr.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Dumić
authors.affiliation: Institute of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Dr. Subotića 1, 11000 Belgrade, Serbia. Electronic address: marko.babic@stomf.bg.ac.rs.
authors.forename: Marko
authors.initials: M
authors.lastname: Babić
mesh_terms: D000293:Adolescent; D002508:Cephalometry; D003430:Cross-Sectional Studies; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008445:Maxillofacial Development / Q000187:drug effects*; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone
keywords: Cephalometry; Human growth hormone; Mandible; Maxillofacial development; Monosomy X; X chromosome