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Impact of Growth Hormone Supplementation on Adult Height in Turner Syndrome: Results of the Canadian Randomized Controlled Trial
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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In the citing paper
“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 the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 [158]
In the citing paper
“A subsequent meta-analysis concluded a similar effect of GH therapy, reporting mean adult height gain of 7.2 cm,168 based on data from the two RCTs that followed non-GH-treated subjects 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]
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Metadata
- 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
- 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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