ESPE Abstracts

Background: The risk of cardiovascular diseases is increased in girls with TS. The influence by combined GH and estrogen treatment on a condition of cardiovascular system is actively discussed.

Objective and hypotheses: We performed this study to assess th effects of combined GH and estrogen treatment on lipid metabolism and systolic function of the left ventricle (LV) in girls with Turner syndrome without clinically relevant cardiac abnormalities.

Method: 16 girls with TS 12.2±0.9 years old, not treated before, were recruited in the study and treated with GH (0.05 mg/kg per daily) and estrogens (17β-estradiol, applicated 0.25–0.5–1 mg/daily with a dose increase every 6 months) during 2 years. Anthropometry and systemic blood pressure (BP) were 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).

Results: The height gain was 14.9±2.6 cm over a period of treatment. Mean BP was within the age-related normal range and without statistically significant changes before and during 2 years of treatment. During 2 years of GH-therapy TH was significally decreased from 5.1±1.1 to 4.6±0.7 mmol/l (P=0.023) and LDL was significally decreased from 3.3±0.9 to 2.7±0.7 mmol/l (P=0.0003). TG and HDL levels were not changed related to baseline. At baseline the LV dimensions of all the girls were within normal range. LVED was significally increased from 45.2±10.1 to 57.1±10.7 (P=0.0002), LVES was significally increased from 17.4±4.9 to 21.6±5.3 (P=0.00012) during 2 years of therapy. There were not significant changes in LVEF between baseline and 2-years timepoint. These data give evidence that systolic function of the left ventricle did not become lower.

Conclusion: Combined GH and estrogen treatment in girls with TS improved the lipid profile and did not impair the systolic function of the left ventricle.