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Cited by 256Growth Hormone and Insulin-like Growth FactorsGenetic and Clinical Aspects of Sex Determination and Chromosomal AbnormalitiesHypothalamic control of reproductive hormones

Impact of growth hormone supplementation on adult height in Turner syndrome: results of the Canadian randomized controlled trial

David K. Stephure·2005·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2004-2187
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Abstract

BACKGROUND: A randomized, controlled trial of GH supplementation to adult height in girls with short stature due to Turner syndrome was conducted in Canada. We report results in subjects who completed the protocol and subjects who participated in follow-up. METHODS: One hundred fifty-four girls with Turner syndrome, aged 7-13 yr, were randomly assigned to one of two groups: 1) GH by sc injection six times per week (0.30 mg/kg.wk), and 2) control (C), no GH treatment. Both cohorts received standardized sex steroid replacement starting at a chronological age of 13 yr. Subjects were followed until protocol completion, defined as height velocity less than 2 cm/yr and bone age 14 yr or greater. A subsequent protocol addendum requested follow-up safety and efficacy assessment in all patients at least 1 yr after the last core protocol visit. RESULTS: One hundred four patients completed the study (61 GH, 43 C), and 50 withdrew (15 GH, 35 C). At protocol completion, mean heights were 147.5 +/- 6.1 (GH) and 141.0 +/- 5.4 cm (C), respectively (P < 0.001). Of those who completed the protocol, 59 (40 GH, 19 C) had height data at least 1 yr after protocol completion; in that group, mean heights were 149.0 +/- 6.4 (GH) and 142.2 +/- 6.6 cm (C), respectively (P < 0.001). At protocol completion and follow-up, the mean height gain due to GH, estimated by analysis of covariance, was +7.2 cm (confidence interval 6.0, 8.4) and +7.3 cm (confidence interval 5.4, 9.2), respectively (both P < 0.001). CONCLUSIONS: This is the first evidence from a randomized, controlled trial to adult height that GH supplementation with induction of puberty at a near physiological age increases the adult height of girls with Turner syndrome.

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  • Only six RCTs have compared GH treatment with concurrent non-treatment or placebo control for at least one year.

    “Despite numerous studies of GH treatment in TS, only six randomized, controlled trials (RCTs) have compared GH treatment with a concurrent non-treatment or placebo control for at least one year157-162”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [158]

  • In two clinical trials, adult height was within normal range for 40-50% of treated vs 4-16% of non-GH treated individuals.

    “In the two clinical trials that maintained long-term untreated/placebo controls, adult height was within the normal range for 40%-50% of treated individuals vs. 4%-16% percent of non-GH treated individuals.158,160”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [158]

  • Only two of these trials have followed non-GH-treated participants to adult height.

    “and only two of these trials have followed non-GH-treated participants to adult height.158,160”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [158]

  • After 2 years of treatment, height velocity was ~2 cm/year greater for treated than untreated girls in the study that continued the control arm long term.

    “after 2 years of treatment height velocity was ∼2 cm year−1 greater for treated than untreated girls in the study that continued the control arm long term.158”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [158]

  • A 2007 Cochrane review concluded that girls treated with GH grew 3 cm/year more than untreated girls in the first 12-18 months.

    “a 2007 Cochrane Center review156 concluded that girls treated with GH grew 3 cm year−1 more than untreated girls in the first 12-18 months of therapy”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [158]

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Authors
Stephure, D. K.
Affiliations
University of Calgary (CA)
Corresponding author
David K. Stephure
ORCID
David K. Stephure
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2005-06-01
Volume
90
Issue
6
Pages
3360-3366
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2004-2187
OpenAlex
W2438709008
Cited by
256
References
25
Citations by year
2026: 6 · 2025: 3 · 2024: 13 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 15 · 2018: 11 · 2017: 8 · 2016: 15 · 2015: 13 · 2014: 12 · 2013: 15 · 2012: 19
FWCI
11.81
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
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, adult height, short stature, puberty induction, height gain, long-term follow-up
MeSH terms
Adolescent, Body Height, Female, Follow-Up Studies, Humans, Karyotyping, Phenotype, Turner Syndrome, Reproducibility of Results, Human Growth Hormone, Chromosomes, Human, Y

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