Original Paper

Effects of Growth Hormone on Growth, Insulin Resistance and Related Hormones (Ghrelin, Leptin and Adiponectin) in Turner Syndrome
Feyza Darendeliler^a, Zehra Aycan^b, Ergun Cetinkaya^b, Sadi Vidilisan^b, Firdevs Bas^a, Aysun Bideci^c, Fatma Demirel^c, Sukran Darcan^d, Atilla Buyukgebiz^e, Metin Yildiz^g, Merih Berberoglu^f, Ilknur Arslanoglu^g, Ruveyde Bundak^a

Pediatric Endocrinology Unit, Departments of Pediatrics,
^aIstanbul University, Istanbul Faculty of Medicine, Istanbul,
^bSSK Ankara Children's Hospital and
^cGazi University, School of Medicine, Ankara,
^dEge University, School of Medicine, and
^eDokuz Eylul University, School of Medicine, Izmir,
^fAnkara University, School of Medicine, Ankara, and
^gDivision of Pediatric Endocrinology, SSK Goztepe Educational Hospital, Istanbul, Turkey

Address of Corresponding Author

Horm Res 2007;68:1-7 (DOI: 10.1159/000098440)

  Key Words

• Childhood
• Growth hormone therapy
• GH therapy, metabolic effects
• Insulin resistance
• Adiponectin
• Ghrelin
• Leptin
• Turner syndrome

  Abstract

Background:Concomitant evaluation of the metabolic and growth-promoting effects of growth hormone (GH) therapy in Turner syndrome (TS) may be used in the prediction of the growth response to GH therapy. Aim: To evaluate the metabolic effects of GH therapy in TS and correlation with the short-term growth response. Patients: 24 prepubertal children with TS, aged 9.4 ± 2.6 years were followed for auxology and IGF-I, IGFBP-3, leptin, ghrelin, adiponectin, lipids and OGTT results in a prospective multicenter study. Intervention: GH (Genotropin®) in a dose of 50 µg/kg/day for 1 year. Results: Height standard deviation score (SDS) increased from -3.9 ± 1.5 to -3.5 ± 1.4 (p = 0.000) on therapy. BMI did not change. IGF-I SDS increased from -2.3 ± 0.4 to -1.6 ± 1.1 at 3 and 6 months (p = 0.001) and decreased thereafter. Serum leptin decreased significantly from 2.3 ± 3.9 to 1.7 ± 5.3 ng/ml (p = 0.022) at 3 months and increased afterwards. Serum ghrelin decreased from 1.2 ± 0.8 to 0.9 ± 0.4 ng/ml (p = 0.005) with no change in adiponectin. Basal and stimulated insulin levels also increased significantly. height SDS over 1 year showed a significant correlation with IGF-I_{0-3 months} (r = 0.450, p = 0.027). Conclusion: IGF-I may be considered as a marker of growth response in TS at short term. Leptin shows a decrease at short term but does not have a correlation with growth response. The decrease in ghrelin in face of unchanged weight seems to be associated with increase in IGF-I and insulin levels. The unchanged adiponectin levels in spite of an increase in insulin levels indicates that adiponectin is mainly affected by weight, not insulin.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Feyza Darendeliler
stanbul Tp Fakültesi, Çocuk Klinii
Çapa 34390, Istanbul (Turkey)
Tel. +90 216 332 0212 or +90 212 635 1189
Fax +90 212 533 1383, E-Mail feyzad@istanbul.edu.tr

  Article Information

Received: August 4, 2006
Accepted: November 14, 2006
Published online: January 5, 2007
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 2, Number of References : 44