Journal of Clinical Endocrinology & Metabolism, Vol 74, 619-622, Copyright © 1992 by Endocrine Society
Low urinary growth hormone values in patients with Turner's syndrome
H Kohno and S Honda
Department of Endocrinology and Metabolism, Fukuoka Children's Hospital, Japan.
Short stature is one of the major symptoms in Turner's syndrome (TS). The
cause of short stature is not clearly known at present. In this study we
initially assessed GH secretory status in TS by determinations of urinary
human (h) GH excretion for 2 consecutive days. Secondly, the therapeutic
dose of hGH used for treatment of short stature in TS was evaluated by
measurements of urinary hGH after recombinant hGH (r-hGH) injections.
Twenty-four-hour urinary hGH excretion for the 2 days combined was
significantly lower in patients with TS than in normal children [2.3 +/-
1.8 ng/day (n = 7) vs. 13.4 +/- 3.2 (n = 16); P less than 0.001], although
four of seven patients with TS had normal GH responses to the provocative
tests. The mean level of urinary hGH in TS after 2 days was comparable to
that in complete GH deficiency (1.9 +/- 0.9 ng/day; n = 14) that we
previously reported. Treatment with daily sc injections of 1.0 IU (0.37
mg)/kg.week r-hGH, given in seven divided doses, normalized urinary hGH
excretion and induced remarkable catch-up growth in all patients with TS.
These results indicate that the 24-h endogenous GH secretion in seven
patients with TS is impaired. The measurement of 24-h urinary hGH excretion
may prove to be useful as a marker to assess the abnormal GH secretion and
the adequacy of treatment with hGH in patients with TS. The therapeutic
dose of hGH in TS is approximately 0.37 mg/kg.week, given in seven divided
doses. To convert international units of r-hGH to milligrams, divide by
2.7.
