ESPE Abstracts

Purpose: Growth hormone (GH) treatment has become common practice in Turner syndrome (TS) to improve final adult height. However, there are only a few studies on the analysis of good responders to GH treatment in TS. The aim of this study is to predict the responsiveness to growth hormone therapy in Turner syndrome.

Methods: Among 197 TS patients registered in LG Growth study, 92 patients were excluded because of systemic illness or hypothyroidism. The clinical and biochemical parameters of 105 girls with TS patients were retrospectively reviewed. Patients were divided into subgroups (minimal, intermediate, good responders) according to the increment of height standard deviation score (SDS) during the first year of GH treatment, and the prognostic factors for good responders were identified.

Results: In good responders, chronologic age (CA) and bone age (BA) at the start of GH treatment were significantly earlier than the other groups (P<0.001). They were not significantly associated with initial height SDS, GH dose, midparental height (MPH), predicted adult height (PAH). Accordingly, height response was significantly related with earlier CA and BA at start of GH treatment (P<0.001). Especially, patients who started GH treatment before 7 years showed significantly higher height SDS increment than patients treated after 7 years (P<0.001). Additionally, the starting age of estrogen therapy was not significantly correlated with height SDS increment in estrogen treatment group.

Conclusion: This study suggests that CA and BA at the start of GH treatment are significant factors in good responders in TS patients. Early intervention with growth hormone treatment is needed in TS patients.