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Cited by 25Growth Hormone and Insulin-like Growth FactorsGenetic and Clinical Aspects of Sex Determination and Chromosomal AbnormalitiesHypothalamic control of reproductive hormones

Prevention of growth failure in Turner syndrome: long-term results of early growth hormone treatment in the “toddler Turner” cohort

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Quigley, Charmian A., Fechner, Patricia Y., Geffner, Mitchell E., Eugster, Erica A., Ross, Judith L., Habiby, Reema L., Ugrasbul, Figen, Rubin, Karen +4 more·2021·Hormone Research in Paediatrics
DOI 10.1159/000513788
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Abstract

INTRODUCTION: In the randomized "Toddler Turner" study, girls who received growth hormone (GH) starting at ages 9 months to 4 years (early-treated [ET] group) had marked catch-up growth and were 1.6 ± 0.6 SD taller than untreated (early-untreated [EUT]) control girls after 2 years. However, whether the early catch-up growth would result in greater near-adult height (NAH) was unknown. Therefore, this extension study examined the long-term effects of toddler-age GH treatment on height, pubertal development, and safety parameters. METHODS: Toddler Turner study participants were invited to enroll in a 10-year observational extension study for annual assessments of growth, pubertal status, and safety during long-term GH treatment to NAH for both ET and EUT groups. RESULTS: The ET group was taller than the EUT group at all time points from preschool to maturity and was significantly taller at the onset of puberty (p = 0.016), however, the difference was not significant at NAH. For the full cohort (ET + EUT combined, n = 50) mean (± SD) NAH was 151.2 ± 7.1 cm at age 15.0 ± 1.3 years. NAH standard deviation score (SDS) was within the normal range (>-2.0) for 76% of ET and 60% of EUT subjects (68% overall) and correlated strongly with height SDS at GH start (r = 0.78; p < 0.01), which in turn had a modest inverse correlation with age at GH start (i.e., height SDS declined with increasing age in untreated girls [r = -0.30; p = 0.016]). No new safety concerns arose. CONCLUSION: Although the ET group was taller throughout, height SDS at NAH was not significantly different between groups due to catch-down growth of ET girls during lapses in GH treatment after the Toddler study and similar long-term GH exposure overall. Early initiation of GH by age 6 years, followed by uninterrupted treatment during childhood, can prevent ongoing growth failure and enable attainment of height within the normal range during childhood, adolescence, and adulthood.

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  • In the long-term extension of the Toddler Turner Study, early treated girls were taller at all key childhood timepoints and at puberty.

    “In the long-term extension of the Toddler Turner Study, the early treated girls were taller at all key childhood timepoints and at puberty.163”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [163]

  • Younger age at treatment initiation, including at least 4 years of treatment prior to puberty, is associated with greater GH treatment effect.

    “Younger age at treatment initiation,158,162,163 including at least 4 years of treatment prior to puberty,175,179,180 is associated with greater GH treatment effect.”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [163]

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Research works printed but not linked: 18

  1. Rochiccioli P, David M, Malpuech G, Colle M, Limal JM, Battin J, Mariani R, Sultan C, Nivelon JL, Simonin G et al: Study of final height in Turner's syndrome: ethnic and genetic influences. Acta Paediatr 1994, 83(3):305-308.
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  3. Quigley CA, Crowe BJ, Anglin DG, Chipman JJ: Growth hormone and low dose estrogen in Turner syndrome: results of a United States multi-center trial to near-final height. J Clin Endocrinol Metab 2002, 87(5):2033-2041.
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Authors
Quigley, C. A., Fechner, P. Y., Geffner, M. E., Eugster, E. A., Ross, J. L., Habiby, R. L., Ugrasbul, F., Rubin, K., Travers, S., Antalis, C. J., Patel, H. N., & Davenport, M. L.
Affiliations
  • Sydney Children's Hospital (AU)
  • Seattle Children's Hospital (US)
  • University of Southern California (US)
  • Indiana University Health (US)
  • Thomas Jefferson University Hospital (US)
  • Northwestern University (US)
  • Children's Mercy Hospital (US)
  • Connecticut Children's Medical Center (US)
  • University of Colorado Anschutz (US)
  • Eli Lilly (United States) (US)
  • University of North Carolina at Chapel Hill (US)
ORCID
Venue
Hormone Research in Paediatrics
Publisher
S. Karger AG
Published
2021
Volume
94
Issue
1-2
Pages
18-35
ISSN
  • 1663-2818 (ISSN-L)
  • 1663-2826
DOI
10.1159/000513788
OpenAlex
W3167509936
Cited by
25
References
45
Citations by year
2026: 4 · 2025: 2 · 2024: 5 · 2023: 7 · 2022: 5 · 2021: 2
FWCI
3.54
Type
journal article
Language
en
Open access
Licence
Locations
  • Hormone Research in Paediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
Turner syndrome, growth hormone therapy, catch-up growth, near-adult height, pubertal development, long-term treatment safety
MeSH terms
Adolescent, Body Height, Child, Preschool, Female, Growth Disorders, Humans, Infant, Puberty, Turner Syndrome, Human Growth Hormone

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