PP.38.07

Abstract

Objective: The risk of hypertension is estimated to occur in 7–17% of children and 24–40% of adults with TS. Furthermore, even girls with TS who are normotensive have been shown to have an abnormal circadian blood pressure rhythm, with loss of nocturnal reduction in blood pressure, increasing the risk of end-organ hypertensive damage. We performed this study to assess the effects of GH treatment combine with estrogens for short stature on left ventricular (LV) dimensions, systemic blood pressure (BP) and lipid metabolism in girls with TS without clinically relevant cardiac abnormalities. Design and method: systemic BP assessed every 3 months, LV dimensions measured on echocardiography every 6 months in 20 girls with TS treated GH and estrogens simultaneous. Total cholesterol (TH), low density lipoproteins (LDL), high density lipoproteins (HDL), triglycerides (TG) levels were measured every 6 months. Treatment duration was 2 years. Dose of estradiol gel was 100 mg/daily by transdermal application, GH dose was 0,05 mg/kg/daily subcutaneous. Results: Before the start of GH treatment, mean BP was within the normal range but significantly higher than in healthy control subjects. Diastolic BP and systolic BP were above the 90 percentile. After 2 years of treatment SBP and DBP levels were not significantly different from baseline in both of the groups (p < 0,01). The SD score of the diastolic BP showed f small decrease after 2 years of treatment. At baseline the LV dimensions of all the girls were within normal range, the mean SD scores were close to zero. During 2 years of GH therapy no signs of LV hypertrophy were found. TG and LDL were age-related increased in TS girls. In the course of GH therapy the TG and LDL levels were decreased (p < 0,01). Conclusions: 1. GH treatment does not result in LV hypertrophy or hypertension in girls with TS during 2-years therapy, despite the dramatic body height gain. But continued observation under long-term therapy is recommended. 2. GH therapy combine with estrogens in girls with TS was demonstrated a favored changes in TG and LDL levels that indicates the beneficial impact on atherogenic risk.