ESPE Abstracts (2015) 84 P-2-547

The Impact of Growth Hormone (GH) Therapy Combined with Estrogens on Blood Pressure (BP), Cardiac Left Ventricular (LV) Dimensions and Lipid Metabolism in Pubertal Girls with Turner's Syndrome (TS)

Elena Nagaeva, Tatiana Shiryaeva, Natalia Volevodz, Olga Chikulaeva, Maria Pankratova, Anna Gavrilova & Valentina Peterkova


Endocrinology Research Centre, Moscow, Russia


Background: The risk of hypertension is estimated to occur in 7–17% of children and adolescents with TS. Even girls with TS who are normotensive have been shown an abnormal circadian BP rhythm, increasing the risk of end-organ hypertensive damage.

Objective and hypotheses: We performed this study to assess the effects of GH treatment combined with estrogens for short stature on LV dimensions, systemic BP and lipid metabolism in girls with TS without clinically relevant cardiac abnormalities.

Method: 20 girls with TS 12.4±1.09 years old, not treated before, were recruited in the study and treated with GH (0.05 mg/kg/daily) and estrogens (applicated 100 mg/daily) during 2 years. Anthropometry, systemic BP assessed every 3 months. Total cholesterol (TH), low density lipoproteins (LDL), high density lipoproteins (HDL), triglycerides (TG) levels were measured every 6 months, LV systolic function (LVSF) was estimated by echocardiography every 12 months. The measurement parameters were: LV end diastolic (LVED), LV end systolic (LVES), LV ejection fraction (LVEF). Stroke volume index (SVI) was calculated.

Results: Over a period of treatment height gain was 16.18±2.98 sm. Before the start of GH- treatment, mean BP was within the age-related normal range. After 2 years of treatment systolic BP and diastolic BP levels were not significantly different from baseline. I TH, TG, LDL, LDL levels were not changed related to baseline. At baseline the LV dimensions of all the girls were within normal range, and the mean SD scores were close to zero. During 2 years of GH-therapy LVED was significally increased from 45.23±9.77 to 55.91±9.37(P=0.012), SVI was increased accordingly from 25.30±2.67 to 29.86±2.25 (P=0.019). There were not significant changes in LVES and LVEF between baseline and 2-years timepoint. These data give evidence that myocardial contractility was improved.

Conclusion: i) GH treatment does not result in LV hypertrophy or hypertension in girls with TS during 2-years therapy, despite the dramatic body height gain. ii) GH-therapy combined with estrogens in girls with TS was not induced 9 change in lipids levels probably because of its levels were in normal ranges at baseline.