Turner syndrome (TS) is a common genetic disorder, affecting approximately 1:2500 live-born females. One of the cardinal features of TS is extreme short stature, the average adult height of U.S. women with TS being 142 cm(4'8”), approximately 20cm (8“) below that of adult women without TS. Treatment with relatively high-dose recombinant human growth hormone (GH) increases final height of patients with TS and is now in wide use. Since patients with TS also have increased risk for development of insulin resistance, carbohydrate intolerance and non-insulin-dependent diabetes mellitus, especially during the teenage years, there has been concern that GH, which stimulates hepatic glucose production and reduces insulin-stimulated glucose utilization, could exacerbate this risk. To date, studies addressing this concern have provided conflicting results, and no placebo-controlled data have been reported. In a large randomized, 18-month placebo-controlled, multi-center study we evaluated the effect of GH on fasting and 2-hour post-prandial blood glucose (BG) and insulin concentrations and HbA1C. Patients received either placebo injections (n=46), GH at 0.27 mg/kg/wk (n=93) or GH at 0.36 mg/kg/wk (n=91), in combination with low dose estrogen or oral placebo. There were no differences at baseline for mean values for these variables between patients in the three primary treatment groups, and all values were normal. The table below summarizes the mean±SD data obtained after 18 months of study. There were no significant differences between mean values for fasting or post-prandial glucose or insulin or for HbA1C, between the group of patients receiving placebo injections and those receiving either 0.27 mg/kg/wk or 0.36 mg/kg/wk of GH. These data indicate that 18 months of GH therapy at the doses used in this study does not impair carbohydrate tolerance or induce insulin resistance in patients with TS.

Table 1 No caption available.
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