Secular trends on birth parameters, growth, and pubertal timing in girls with Turner syndrome
Open accessAbstract
Background: Whether children with chromosomal disorders of growth and puberty are affected by secular trends (STs) as observed in the general population remains unanswered, but this question has relevance for expectations of spontaneous development and treatment responses. Objectives: To study STs in birth parameters, growth and pubertal development in girls with Turner syndrome (TS). Study design: Retrospective analysis of KIGS data (Pfizer International Growth Database). We included all TS patients who entered KIGS between 1987 and 2012 and were born 1975 to 2004, who were pre-pubertal and growth-treatment naïve at first entry (total number: 7219). Pre-treatment height and ages at treatment start were compared across 5-year birthyear groups, with sub-group analyses stratified by induced or spontaneous puberty start. Results: We observed significant STs across the birthyear groups for birth weight (+0.18 SDS, p<0.001), pre-treatment height at mean age 8 years (+0.73 SDS, p<0.001), height at start of GH-therapy (+0.38 SDS, p<0.001) and start of puberty (+0.42 SDS, p<0.001). Spontaneous puberty onset increased from 15% to 30% (p<0.001). Mean age at GH treatment start decreased from 10.8 to 7.4 years (-3.4 years; p<0.001), substantial declines were seen in ages at onset of spontaneous and induced puberty (-2.0 years; p<0.001) and menarche (-2.1 years; p<0.001). Conclusion: Environmental changes leading to increased height and earlier, and also more common, spontaneous puberty are applicable in TS as in normal girls. In addition, greater awareness for TS may underlie trends to earlier start of GH therapy and induction of puberty at a more physiological age.
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After the 2007 TS guidelines were published, the median age at diagnosis has remained high.
“After the 2007 TS guidelines1 were published in part to optimize the screening for TS, the median age at diagnosis has remained high.96,97”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [97]
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
Gravholt, C. H., Andersen, N. H., Christin-Maitre, S., Davis, S. M., Duijnhouwer, A., Gawlik, A., Maciel-Guerra, A. T., Gutmark-Little, I., Fleischer, K., Hong, D., et al. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae050 · Cited by 224 · see citing works
- Authors
- Woelfle, J., Lindberg, A., Aydin, F., Ong, K. K., Camacho-Hubner, C., & Gohlke, B.
- Affiliations
- University of Bonn (DE)
- Pfizer (Sweden) (SE)
- University of Cambridge (GB)
- Corresponding author
- Woelfle, Joachim
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2018-02-28
- Volume
- 9
- Pages
- 54-54
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC5836145
- OpenAlex
- W2789420879
- Cited by
- 12
- References
- 41
- Citations by year
- 2024: 3 · 2023: 3 · 2021: 3 · 2020: 2 · 2019: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Apollo (cc-by)
- Funders
- Medical Research Council (MC_UU_12015/2)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- Turner syndrome, secular trends, birth weight, growth hormone therapy, puberty onset, spontaneous puberty, menarche
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