Metabolic and Cardiac Effects of Growth Hormone Therapy in Children with Turner Syndrome

Abstract

Background: Turner Syndrome (TS) is the most frequent genetic defect in females. TS patients are characterized by growth failure, metabolic and cardiovascular abnormalities. Objective: The study aimed at determining the influence of growth hormone (GH) therapy on TS patients' body composition, metabolic profile, and cardiac functioning. Patients and methods: This clinical trial comprised 54 TS females divided into two subgroups; 29 TS females on GH medication ≥6 months (interventions) made up Group 1 and 25 TS females who didn't start treatment were in Group 2 (controls). Ages were between 6.01 and 17.1 years. Anthropometric measures, skin fold thickness measurements, body composition analysis and blood pressure were recorded. Fasting levels for lipids, blood glucose, and C-peptide were measured. Tissue Doppler Imaging (TDI), M-mode, complete two-dimensional, and Pulsed-Wave Doppler Echocardiography were performed. Results: Patients with TS receiving GH therapy had significantly higher high density lipoprotein cholesterol (HDL-C), waist circumference (WC) for age, hip circumference, bone mass and impaired global myocardial function. Positive correlation between the age of initiating GH therapy and triglyceride levels were observed while negative correlation with height for age and muscle percentage. Homeostatic model assessment-insulin resistance (HOMA-IR) demonstrated a positive relationship with WC and the sum of skin fold thickness percentiles. Conclusion: GH increases HDL-C, WC and bone mass. Increased WC and skinfold thickness are insulin resistance risk factors. Earlier age of patient at start of GH therapy is connected with decreased triglyceride levels and a higher muscle percentage. TDI detected impairment of global myocardial function of both ventricles.