Growth Hormone Combined With Stanozolol in Turner Syndrome
As shown in Table 1, patients receiving treatment were significantly younger compared with those without treatment (P < 0·001); bone age was also significantly lower in the treated group (P < 0·001). Of the 44 treated patients, only 16 have reached their FAH to date, the mean treatment duration of the 16 patients was 2·11 ± 1·06 year; the remaining patients in this group are still under treatment or follow-up. However, all 22 untreated TS patients have reached their FAH or near FAH. Of the study participants that attained FAH, those receiving treatment had significantly greater FAH than those without treatment (151·42 vs 137·75 cm, P < 0·001; Table 1). No significant differences in BMI, BMISDS, GV, HtSDSNOR, HtSDSTS and target height were noted between the groups (P > 0·05; Table 1). The mean of adult height gain was 11 ± 2·98 cm and the predicted adult height was 140·88 ± 3·68 cm in treated patients.
As shown in Table 2, patient age, bone age and BMI significantly increased throughout the duration of treatment (all, P < 0·001). GV was significantly higher in the first to fourth years of treatment compared to baseline levels (P < 0·001) although it decreased with treatment duration. HtSDSNOR and HtSDSTS were significantly higher in all follow-up years of treatment compared to baseline levels (P < 0·001). Moreover, ΔHtSDSNOR and ΔHtSDSTS values were significantly higher in the second to fourth years of treatment compared to those of the first year (P < 0·001). There were no significant differences in ΔBA/ΔCA and BMISDS over time (Table 2).
Two patients developed autoimmune hypothyroidism and were treated with L-tyroxine. Three patients developed significantly increased IGF-1 (>2SD from the normal range), which returned to normal levels 2–4 weeks after discontinuation of treatment. In addition, three patients has fasting blood insulin levels of >20 μU/ml, which returned to normal levels 2–4 weeks after discontinuation of treatment, after which therapy was resumed. No significant liver or kidney dysfunction was noted (Table 3). Neither abnormal blood pressure nor virilization was observed prior to or throughout the period of treatment. Four patients were noted to have spontaneous pubertal development.
Results
Comparison of Baseline Characteristics and FAH Between Subjects With and Without Treatment
As shown in Table 1, patients receiving treatment were significantly younger compared with those without treatment (P < 0·001); bone age was also significantly lower in the treated group (P < 0·001). Of the 44 treated patients, only 16 have reached their FAH to date, the mean treatment duration of the 16 patients was 2·11 ± 1·06 year; the remaining patients in this group are still under treatment or follow-up. However, all 22 untreated TS patients have reached their FAH or near FAH. Of the study participants that attained FAH, those receiving treatment had significantly greater FAH than those without treatment (151·42 vs 137·75 cm, P < 0·001; Table 1). No significant differences in BMI, BMISDS, GV, HtSDSNOR, HtSDSTS and target height were noted between the groups (P > 0·05; Table 1). The mean of adult height gain was 11 ± 2·98 cm and the predicted adult height was 140·88 ± 3·68 cm in treated patients.
Demographic and Clinical Characteristics of Treated TS Patients Throughout
As shown in Table 2, patient age, bone age and BMI significantly increased throughout the duration of treatment (all, P < 0·001). GV was significantly higher in the first to fourth years of treatment compared to baseline levels (P < 0·001) although it decreased with treatment duration. HtSDSNOR and HtSDSTS were significantly higher in all follow-up years of treatment compared to baseline levels (P < 0·001). Moreover, ΔHtSDSNOR and ΔHtSDSTS values were significantly higher in the second to fourth years of treatment compared to those of the first year (P < 0·001). There were no significant differences in ΔBA/ΔCA and BMISDS over time (Table 2).
Complications During Follow-up
Two patients developed autoimmune hypothyroidism and were treated with L-tyroxine. Three patients developed significantly increased IGF-1 (>2SD from the normal range), which returned to normal levels 2–4 weeks after discontinuation of treatment. In addition, three patients has fasting blood insulin levels of >20 μU/ml, which returned to normal levels 2–4 weeks after discontinuation of treatment, after which therapy was resumed. No significant liver or kidney dysfunction was noted (Table 3). Neither abnormal blood pressure nor virilization was observed prior to or throughout the period of treatment. Four patients were noted to have spontaneous pubertal development.
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