The GH axis was studied in Turner's syndrome (TS) patients. Thirty-seven prepubertal TS patients and 42 normally growing girls (NGG; 5.5-16.3 yr old), of whom 13 were prepubertal, were studied by 24-h continuous blood withdrawal and provocative tests. The 24-h integrated concentrations of GH (IC-GH), FSH (IC-FSH), and insulin-like growth factor-I (IC-IGF-I) as well as the IC-IGF-I/IC-GH ratio were determined. An increase in IC-GH with age and progression of puberty was found in NGG, but not in TS. IC-GH in the NGG was significantly higher than that in age-matched TS patients. Estrogen replacement therapy normalized IC-GH levels in 6 TS patients in whom these levels were subnormal for age. A positive correlation between IC-GH and IC-FSH or IC-estradiol was found in NGG (r = 0.462; P less than 0.01), but not in TS patients. The IC-IGF-I/IC-GH ratio was significantly higher in the TS than in the NGG group. Serum GH-binding activity and serum GH binding to IM9 cells in the TS group did not differ from those in the normal group. We hypothesize that the growth retardation of TS results from a combination of insufficient GH secretion, mainly due to sex steroid deficiency, and an end-organ resistance to IGF-I. IGF-I receptor studies are needed to test this speculation about IGF-I resistance.

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Vitamin A (VA) is required for normal growth and development retinoic acid may be the active metabolite through binding to nuclear receptors. Recently a correlation between nocturnal growth hormone (GH) secretion and VA was found in short slowly growing children. We determined the 24-hour integrated concentration of GH (IC-GH), GH response to provocative stimuli, IGF-I, IGF-binding protein-3 (IGF-BP3) and GH-binding protein (GH-BP) in 34 prepubertal children (25 m/9 f) 5-10 years of age, height -2.5 to 1.5 SDS and body mass index -1.5 to 1.5 SDS for age and sex. Since folic acid, vitamin B₁₂, IGF-I, cholesterol, triglycerides and VA carrier proteins were normal we assumed that no major nutritional deficiency existed. The correlation matrix of the variates tested were p < 0.05 for VA and IC-GH and p < 0.006 for IGF-BP3. It is suggested that VA might have a direct effect on both ICGH and IGF-BP3.

Ethiopian children with TB exhibit a strong cellular immune response as expressed by Mantoux tests and lack of stimulation of IL-4 and IL-6 production. This pattern suggests a Th1 type effective cellular immune response to mycobacteria in a cohort of young Ethiopians with TB.

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