Bondy CA et al. (2006) Growth hormone treatment and aortic dimensions in Turner syndrome. J Clin Endocrin Metab 91: 1785–1788

Growth hormone (GH) is often administered to girls with Turner syndrome to increase adult stature; however, supraphysiologic levels of GH are known to be associated with increased cardiac output and cardiac hypertrophy, which can lead to aortic changes. Increased aortic diameter is a risk factor for aortic dissecting aneurysm (splitting of and bleeding into the aortic wall), an often-fatal condition for which patients with Turner syndrome are already at risk, even without GH treatment. So, Bondy et al. aimed to see whether GH treatment is associated with increased aortic diameter.

Patients with Turner syndrome were recruited via an NIH website. Of these, 101 patients, aged 7–30 years, could supply information on their GH usage: 53 had been receiving GH for ≥2 years and 48 had never received GH. MRI was used to measure the diameter of the ascending and descending aorta, and to ascertain whether a bicuspid aortic valve (a defect associated with aortic aneurysm) was present.

The participants were not randomly allocated, but baseline characteristics of the groups were similar (although GH-treated patients were 8 cm taller on average). Aortic diameter was larger in the GH group than in controls, but multiple regression analysis showed that this was a result of the increased height conferred by GH treatment, and was not related to history or length of GH treatment. Similar numbers of patients in each group had bicuspid aortic valves.

Further randomized studies are needed to test the reproducibility of these findings, and to explore the longer-term effects of GH treatment.