METHIONYL GROWTH HORMONE (met-GH) IN A DOSAGE OF 4 IU/m2 DAY PROMOTES GROWTH IN TURNER SYNDROME

Abstract

In a Dutch multi-center study 16 girls with Turner Syndrome were treated with met-GH in a dosage of 4 IU/m2 body surface administered s.c. once a day. In girls older than 13 years low-dose ethinyl-estradiol (EE) therapy (0.1 ug/kg body weight o.d.) was added. Ages ranged from 7.9 to 15.2 years and bone age from 6.0 to 12 “years”. Heights, expressed as standard deviation scores, were between -2.5 and -5.1 (median -3.9). Endogenous GH secretion was assessed by arginine infusion, exercise test, GRF (1-29)-test and plasma SM-C/IGF-I. Mean ( ± S.D.) growth velocities were: During the first 6 months of therapy the mean ( ± S.D.) bone age (Greulich and Pyle) advanced from 9.1 (±1.2) to 9.4 (±1.2)“years” and the predicted adult height from 148.2 (±4.5) to 151.0 (±4.2) cm. The growth response (growth velocity during 9 months of therapy minus baseline) ranged from 0.8 to 7.0 cm/year and was negatively correlated with chronological age (r= -0.48, p<0.05). In the 4 girls older than 13 years, who also received EE, the growth response was 3.3 ± 0.9, compared to 4.0 ± 1.6 in younger girls. Growth response was not correlated with maximum plasma GH levels during provocation tests. Anti-GH antibodies with a binding capacity of > 0.2 U/l were found in 5 out of 10 patients. In one of them a very high value (3.7 U/l) was found.