Turner症候群におげる成長ホルモン (GH) 分泌能とGH治療効果の検討

下垂体小人症との比較

抄録

The relations of GH secretion capacity by stimulation tests to clinical characteristics and the effect of GH treatment were studied in 151 girls with Turner syndrome and were compared with those in 128 patients with pituitary dwarfism.
GH secretion capacity expressed by mean peak GH was not associated with clinical characteristics related to growth such as height SDS and growth velocity SDS in Turner syndrome and was influenced by % overweight, whereas it was associated with growth-related clinical characteristics in pituitary dwarfism. Because GH secretion capacity does not affect growth in Turner syndrome, it is not reasonable to diagnose low peak GH in stimulation tests as GH deficiency in Turner syndrome.
GH treatment increased the growth velocity and growth velocity SD score in Turner syndrome in a dose-dependent manner. In pituitary dwarfism, the effect of GH treatment expressed by the increase in growth velocity SD score had a negative correlation with growth velocity SD score before GH treatment and GH secretion capacity, which indicated that GH treatment was replacement therapy. In Turner syndrome, the effect of GH treatment had a negative correlation with growth velocity and growth velocity SD score before GH treatment, but had no relation to GH secretion capacity, which suggested that GH treatment did not provide replacement GH but had another pharmacological effect.