Value of GH treatment in Turner syndrome questioned

2019-05-20T08:28:14+00:00April 30th, 2019|News, News report, Paediatric endocrinology|

medwireNews: Health-related quality of life (HRQoL) in women with Turner syndrome bears little or no relation to their height and whether they received growth hormone (GH) treatment as a child, say researchers.

“It is known from clinical experience that height is a main concern, especially for the younger women and girls with [Turner syndrome] and/or their parents”, say Emily Krantz (The Sahlgrenska Academy, Gothenburg, Sweden) and study co-authors.

Yet, among 178 women with Turner syndrome who completed at least one HRQoL questionnaire during 20 years of follow-up, life quality did not significantly differ between those who had and those who had not received GH in childhood, and HRQoL scores were not associated with adult height.

The study participants completed the Psychological General Well-Being index (PGWB) and the Nottingham Health Profile (NHP). The only element to show any significance was the Emotional Reactions subscale of the NHP, which was associated with height but not past GH treatment.

But the researchers say that “[t]he clinical relevance of this association is questionable since there were no significant associations found between the conceptually similar subscales in the PGWB (Anxiety and Depressed mood) and height.”

Instead, HRQoL was related to age, age at diagnosis, and factors such as use of analgesics and antidepressants, they report in The Journal of Clinical Endocrinology & Metabolism.

“[O]ur findings call into question whether treating short stature in childhood with such a cumbersome and expensive treatment is justified when the height-gain is relatively small”, at an average of 5.7 cm, say Krantz and team.

“There is also a risk that the treatment contributes to ‘health-care fatigue’ in childhood that may cause the young women on the cusp of transition to adult care to abstain from further monitoring which may put them at greater risk later in life unnecessarily.”

Of note, overall HRQoL of the women with Turner syndrome was little different to that of 317 women without the condition.

The researchers say this contradicts previous research that found poorer life quality in women with Turner syndrome, but add that the low response and follow-up rates in the earlier study “affects generalizability and may explain the differences in results”.

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

J Clin Endocrinol Metab 2019; doi:10.1210/jc.2019-00340

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