TY - JOUR
T1 - Bone mineral density assessed by phalangeal radiographic absorptiometry before and during long-term growth hormone treatment in girls with Turner's syndrome participating in a randomized dose-response study
AU - Sas, Theo C.J.
AU - De Muinck Keizer-Schrama, Sabine M.P.F.
AU - Stijnen, Theo
AU - Van Teunenbroek, Arne
AU - Van Leeuwen, Wibeke J.
AU - Asarfi, Anjalie
AU - Van Rijn, Rick R.
AU - Drop, Stenvert L.
PY - 2001
Y1 - 2001
N2 - To assess bone mineral density (BMD) in girls with Turner's syndrome before and during long-term treatment with GH, longitudinal measurements using phalangeal radiographic absorptiometry were performed in 68 girls with Turner's syndrome. These previously untreated girls, age 2-11 y, participating in a randomized, dose-response trial, were randomly assigned to one of three GH dosage groups: group A, 4 IU/m2/d (≈0.045 mg/kg/d); group B, first year 4 IU/m2/d, thereafter 6 IU/m2/d (≈0.0675 mg/kg/d); or group C, first year 4 IU/m2/d, second year 6 IU/m2/d, thereafter 8 IU/m2/d (≈0.090 mg/kg/d). In the first 4 y of GH treatment, no estrogens for pubertal induction were prescribed to the girls. Thereafter, girls started with 17β-estradiol (5 μg/kg body weight/d, orally) when they had reached the age of 12 y. BMD results were adjusted for bone age and sex, and expressed as SD scores using reference values of healthy Dutch girls. At baseline, almost every individual BMD value of bone consisting predominantly of cortical bone, as well as that of bone consisting predominantly of trabecular bone, was within the normal range of healthy girls and the SD scores were not significantly different from zero [mean (SE) 0.38 (0.22) and -0.04 (0.13)]. During 7 y of GH treatment, BMD SD scores showed a significant increase to values significantly higher than zero [mean (SE) 0.87 (0.15) and 0.95 (0.14)]. The increment in BMD SD score of bone consisting predominantly of cortical bone was significantly higher in group C compared with that of the other two GH dosage groups. The pretreatment bone age was significantly negatively related to the increment in BMD SD score. We found no significant influence of spontaneous puberty or the use of low-dose estrogens in the last 3 y of the study period on the increment in BMD SD score during 7 y of GH treatment. In conclusion, most untreated young girls with Turner's syndrome have a normal volumetric BMD. During 7 y of GH treatment with 4, 6, or 8 IU/m2/d, the BMD SD score increased significantly.
AB - To assess bone mineral density (BMD) in girls with Turner's syndrome before and during long-term treatment with GH, longitudinal measurements using phalangeal radiographic absorptiometry were performed in 68 girls with Turner's syndrome. These previously untreated girls, age 2-11 y, participating in a randomized, dose-response trial, were randomly assigned to one of three GH dosage groups: group A, 4 IU/m2/d (≈0.045 mg/kg/d); group B, first year 4 IU/m2/d, thereafter 6 IU/m2/d (≈0.0675 mg/kg/d); or group C, first year 4 IU/m2/d, second year 6 IU/m2/d, thereafter 8 IU/m2/d (≈0.090 mg/kg/d). In the first 4 y of GH treatment, no estrogens for pubertal induction were prescribed to the girls. Thereafter, girls started with 17β-estradiol (5 μg/kg body weight/d, orally) when they had reached the age of 12 y. BMD results were adjusted for bone age and sex, and expressed as SD scores using reference values of healthy Dutch girls. At baseline, almost every individual BMD value of bone consisting predominantly of cortical bone, as well as that of bone consisting predominantly of trabecular bone, was within the normal range of healthy girls and the SD scores were not significantly different from zero [mean (SE) 0.38 (0.22) and -0.04 (0.13)]. During 7 y of GH treatment, BMD SD scores showed a significant increase to values significantly higher than zero [mean (SE) 0.87 (0.15) and 0.95 (0.14)]. The increment in BMD SD score of bone consisting predominantly of cortical bone was significantly higher in group C compared with that of the other two GH dosage groups. The pretreatment bone age was significantly negatively related to the increment in BMD SD score. We found no significant influence of spontaneous puberty or the use of low-dose estrogens in the last 3 y of the study period on the increment in BMD SD score during 7 y of GH treatment. In conclusion, most untreated young girls with Turner's syndrome have a normal volumetric BMD. During 7 y of GH treatment with 4, 6, or 8 IU/m2/d, the BMD SD score increased significantly.
UR - http://www.scopus.com/inward/record.url?scp=0034876914&partnerID=8YFLogxK
U2 - 10.1203/00006450-200109000-00019
DO - 10.1203/00006450-200109000-00019
M3 - Article
C2 - 11518831
AN - SCOPUS:0034876914
SN - 0031-3998
VL - 50
SP - 417
EP - 422
JO - Pediatric Research
JF - Pediatric Research
IS - 3
ER -