The Interactive Effect of GHR-Exon 3 and −202 A/C IGFBP3 Polymorphisms on rhGH Responsiveness and Treatment Outcomes in Patients with Turner Syndrome
Abstract
CONTEXT: There is great interindividual variability in the response to recombinant human (rh) GH therapy in patients with Turner syndrome (TS). Ascertaining genetic factors can improve the accuracy of growth response predictions. OBJECTIVE: The objective of the study was to assess the individual and combined influence of GHR-exon 3 and -202 A/C IGFBP3 polymorphisms on the short- and long-term outcomes of rhGH therapy in patients with TS. DESIGN AND PATIENTS: GHR-exon 3 and -202 A/C IGFBP3 genotyping (rs2854744) was correlated with height data of 112 patients with TS who remained prepubertal during the first year of rhGH therapy and 65 patients who reached adult height after 5 ± 2.5 yr of rhGH treatment. MAIN OUTCOME MEASURES: First-year growth velocity and adult height were measured. RESULTS: Patients carrying at least one GHR-d3 or -202 A-IGFBP3 allele presented higher mean first-year growth velocity and achieved taller adult heights than those homozygous for GHR-fl or -202 C-IGFBP3 alleles, respectively. The combined analysis of GHR-exon 3 and -202 A/C IGFBP3 genotypes showed a clear nonadditive epistatic influence on adult height of patients with TS treated with rhGH (GHR-exon 3 alone, R² = 0.27; -202 A/C IGFBP3, R² = 0.24; the combined genotypes, R² = 0.37 at multiple linear regression). Together with clinical factors, these genotypes accounted for 61% of the variability in adult height of patients with TS after rhGH therapy. CONCLUSION: Homozygosity for the GHR-exon3 full-length allele and/or the -202C-IGFBP3 allele are associated with less favorable short- and long-term growth outcomes after rhGH treatment in patients with TS.
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Results from studies of girls with TS are contradictory regarding the effect of d3 alleles on growth response.
“However, the results from studies of girls with TS are contradictory with some finding a significant effect on height velocity, total gain in height and adult height in girls with TS carrying one or two d3 alleles.130-132 Other studies did not find an effect.133-135”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [134]
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
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Self-citation
- Authors
- Braz, A. F., Costalonga, E. F., Montenegro, L. R., Trarbach, E. B., Antonini, S. R. R., Malaquias, A. C., Ramos, E. S., Mendonca, B. B., Arnhold, I. J. P., & Jorge, A. A. L.
- Affiliations
- Universidade de São Paulo (BR)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- Corresponding author
- Jorge, Alexander A. L.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-04
- Volume
- 97
- Issue
- 4
- Pages
- E671-E677
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2051644961
- Cited by
- 21
- References
- 30
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 1 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 2
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Physical Performance
- Keywords
- Turner syndrome, recombinant human growth hormone therapy, epistasis, adult height, growth rate, short stature
- MeSH terms
- Adult, Alleles, Body Height, Brazil, Drug Resistance, Exons, Female, Homozygote, Humans, Promoter Regions, Genetic, Receptors, Somatotropin, Recombinant Proteins, Turner Syndrome, Treatment Outcome, Gene Deletion, Insulin-Like Growth Factor Binding Protein 3, Human Growth Hormone, Hormone Replacement Therapy, Polymorphism, Single Nucleotide, Genetic Association Studies
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