Abstract
The age related decline in spontaneous growth hormone (GH) secretion has been suggested to cause growth failure in girls with Turner syndrome (TS). We studied 23 girls (mean age: 11.1 yrs with 95% confidence intervals (CI) 9.9 to 12.3) diagnosed to have Turner syndrome by karyotype analysis. 15 prepubertal age-matched subjects (mean age: 11.6 yrs with CI 10.4 to 12.8) with growth retardation due to familial short stature and/or constitutional growth delay were chosen as controls. Spontaneous 12-hour nocturnal GH secretion was assessed by RIA at 30 minutes intervals. Plasma IGF-1 levels were determined by RIA after acid-ethanol extraction. In TS, the percentage of ideal body weight was significantly higher than controls (mean: 127.5 with CI 116 to 139 in TS, and 100.3 with CI 96 to 104.5 in controls; P = 0.0005), and correlated with bone age (r= 0.62, P < 0.005). Spontaneous GH secretion was significantly lower in TS than controls (mean: 3.2 ng/ml with CI 2.5 to 3.9 in TS, and 5.4 ng/ml with CI 4.8 to 6.0 in controls; P < 0.0001). No significant difference was found in IGF-1 levels. In controls, GH concentrations correlated with bone age (r= 0.56, P < 0.05), whereas in TS no correlation was found. Interestingly, in TS GH levels negatively correlaled with percentage of ideal body weight (r= - 0.43, P < 0.05). Our results, confirming that obesity is a common finding in girls with TS, at least in the age range of our patients, suggest that overweight might be the key factor in determining the subnormal spontaneous GH secretion. On the basis of our previous observations showing a close inverse relationship between body weight and serum IGFBP-1 levels in TS, it might be hypothesized that obesity, probably by increasing insulin secretion, would reduce IGFBP-1 levels eventually leading to an enhancement of IGF negative feed-back effect on GH secretion.
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Cianfarani, S., Vaccaro, F., Pasquino, A. et al. GROWTH HORMONE INSUFFICIENCY IN TURNER SYNDROME: IS BODY WEIGHT THE KEY FACTOR?. Pediatr Res 33 (Suppl 5), S30 (1993). https://doi.org/10.1203/00006450-199305001-00160
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DOI: https://doi.org/10.1203/00006450-199305001-00160