Long-Term Follow-Up of GH-Treated Girls with Turner Syndrome: Metabolic Consequences

Abstract

Aims: To investigate the metabolic consequences of long-term GH treatment in young women with Turner syndrome (TS), several years after GH discontinuation. Methods: Follow-up study of a randomized GH dose-response trial, with 3 GH dosages (1.3, 2.0, and 2.7 mg/m²/day). Thirty-nine TS patients (20.0 ± 2.1 years) participated 4.8 ± 1.9 years after GH discontinuation. Mean GH treatment duration was 8.7 ± 2.0 years. Fasting glucose, insulin, and serum lipids were measured. Results: Several years after GH discontinuation, insulin sensitivity remained lower, while β-cell function and fasting insulin levels remained higher than before treatment. Only BMI influenced β-cell function. Serum total cholesterol (TC), low-density lipoprotein and high-density lipoprotein (HDL) had further increased compared to 6 months after GH, resulting in higher TC, but also higher HDL levels compared to controls. The atherogenic index remained constant, but lower than controls. Conclusions: Besides height, GH therapy in girls with TS has additional beneficial effects on serum lipids. Nearly 5 years after discontinuation of GH therapy the favorable effect of GH was still noticeable. The GH-induced decrease in insulin sensitivity, however, remained unchanged, possibly due to having TS.

Effect of Oxandrolone on Glucose Metabolism in Growth Hormone-Treated Girls with Turner Syndrome

“…In accordance with our findings, several other studies found that insulin sensitivity decreased during GH therapy [6,9,26,27,28]. These studies showed that after discontinuing GH therapy, insulin sensitivity indices either returned to pre-treatment levels [27], or decreased to values just above baseline but comparable with those of healthy post-pubertal girls [29]. In our study, the indices returned to pretreatment levels, confirming the reversibility of the effect of GH on insulin sensitivity.…”

TRANSITION IN ENDOCRINOLOGY: Treatment of Turner's syndrome during transition

“…During the last decade many studies showed growth hormone (GH) treatment as safe and effective for growth promotion in TS. Table 2 presents the results of growth therapy and indicates positive, negative and neutral determinants of therapy effectiveness as well as consequences and side effects of hormonal therapy in the analysed articles (4,5,7,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50).…”

Endocrine diseases, perspectives and care in Turner syndrome

“…Some studies have reported the improvement of some lipid profile parameters, such as decrease in lipoprotein A, apoprotein A-I and increase in HDL cholesterol after the beginning of estrogen replacement. The administration of rhGH also improves the lipid profile by reducing total cholesterol and LDL cholesterol and increasing HDL (41,43). Androgen replacement therapy presents controversial effects on lipid metabolism in patients with TS.…”