The influence of growth hormone monotherapy and growth hormone in combination with oxandrolone or testosterone on thyroxid hormone parameters and thyrxine binding globulin in patients with Ullrich- Turner syndrome

Schimrigk, К.; Häusler, Gabriele; Blümel, Peter; Plöchl, E; Waldhör, Thomas; Frisch, H

doi:10.1007/s004310050563

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…Administration of GH has yielded conflicting results concerning its role on thyroid function in TS girls as well as in patients with other growth diseases. 12,[24][25][26] The significant increase in TT 3 serum levels recorded in this study is in consonance with reports indicating an increased conversion of T 4 to T 3 induced by GH 27 and with our previous results indicating that IGF-I administration increased TT 3 serum levels in the rat. 15 Furthermore the elevated TT3 levels may also indicate a state of relative T 3 resistance, as expected from our finding of reduced expression of TRα 1 and β 1 .…”

Section: Discussionsupporting

confidence: 93%

“…In TS patients, the effect of GH treatment was reported by Massa et al 24 . and Schmitt et al 25 . who did not find significant changes in TSH serum level after GH administration.…”

Section: Discussionmentioning

confidence: 77%

“…Some researchers reported an increased TSH release, 30 whereas others have found no change in either baseline or TRH-stimulated TSH levels 26 or a weak reduction. 31 In TS patients, the effect of GH treatment was reported by Massa et al 24 and Schmitt et al 25 who did not find significant changes in TSH serum level after GH administration. These apparent contradictions to our results could be related to differences in experimental approaches such as GH dose and sample timing.…”

Section: Discussionmentioning

confidence: 87%

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Growth hormone (GH) treatment reduces peripheral thyroid hormone action in girls with Turner syndrome

Susperreguy

Miras

Montesinos

et al. 2007

Clinical Endocrinology

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Section: Discussionsupporting

confidence: 93%

“…In TS patients, the effect of GH treatment was reported by Massa et al 24 . and Schmitt et al 25 . who did not find significant changes in TSH serum level after GH administration.…”

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 87%

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Growth hormone (GH) treatment reduces peripheral thyroid hormone action in girls with Turner syndrome

Susperreguy

Miras

Montesinos

et al. 2007

Clinical Endocrinology

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“…1,2001 chromosome has been shown to be involved in short stature associated with Turner's syndrome". 1,2001 chromosome has been shown to be involved in short stature associated with Turner's syndrome".…”

Section: Discussionmentioning

confidence: 99%

IGF-I Resistance and Turner's Syndrome

Lebl

Průhová²,

Zapletalová³

et al. 2001

Journal of Pediatric Endocrinology and Metabolism

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The pathogenesis of growth failure in Turner's syndrome is not clear but might be attributed to a decreased sensitivity to insulin-like growth factor-I (IGF-I) in distinct cell lines or to its reduced autocrine/paracrine action. Growth hormone (GH) therapy leads to increments in IGF-I levels and to growth acceleration. In order to evaluate the pattern of overcoming IGF-I resistance through childhood and adolescence, we measured IGF-I in 78 girls with Turner's syndrome aged 4.6-18.3 years on 160 occasions without or during GH (1 IU/kg/week [0.33 mg/kg/week]) or GH+estradiol (E2) therapy and compared them with local IGF-I standards. In untreated patients, IGF-I levels were low normal (-0.71+/-0.18 SDS, mean +/- SEM). In both GH or GH+E2 treated girls, circulating IGF-I levels were persistently supraphysiological (GH only: +3.61+/-0.23 SDS; GH + estradiol: +3.18+/-0.31 SDS). The age-dependent pattern of IGF-I secretion was conserved but the pubertal increase occurred earlier. The highest standardized IGF-I levels were observed at age 8.5-9.4 years (+6.62+/-1.00 SDS) and 9.5-10.4 years (+5.61+/-1.03 SDS). GH+E2 substitution had no additional effect on circulating IGF-I. We conclude that high IGF-I levels are needed to overcome the IGF-resistance in Turner's syndrome. They reflect the action of GH therapy but not of estrogens. The earlier pubertal increase of IGF-I might be caused by exaggerated adrenal androgens.

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“…No changes in thyroid parameters were found in a placebo-controlled, double-blind trial of GH therapy (0AE222 mg/kg/week) in non-GHD short children. 22 Of four studies identified using variable pharmacological doses of GH therapy in girls with Turner's syndrome, two demonstrated no change in thyroid parameters 62,63 one showed a decrease in free T4 within the normal range at 6 months of therapy that returned to baseline at 1 year without any alteration in T3 64 and the most recent study found a trend towards a decrease in free T4 and an increase in T3 and TSH, all within the normal range. 65 None of the subjects became clinically or biochemically hypothyroid during GH administration, suggesting that GH unmasks rather than induces CH in at risk groups with organic pituitary disease.…”

Section: Growth Hormone Effect On the Thyroid Axismentioning

confidence: 99%

The interaction between growth hormone and the thyroid axis in hypopituitary patients

Behan

Monson

Agha

2011

Clinical Endocrinology

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SummaryAlterations in the hypothalamo-pituitary-thyroid axis have been reported following growth hormone (GH) administration in both adults and children with and without growth hormone deficiency. Reductions in serum free thyroxine (T4), increased tri-iodothyronine (T3) with or without a reduction in serum thyroid-stimulating hormone secretion have been reported following GH replacement, but there are wide inconsistencies in the literature about these perturbations. The clinical significance of these changes in thyroid function remains uncertain. Some authors report the changes are transient and revert to normal after a few months or longer. However, in adult hypopituitary patients, GH replacement has been reported to unmask central hypothyroidism biochemically in 36-47% of apparently euthyroid patients, necessitating thyroxine replacement and resulting in an attenuation of the benefit of GH replacement on quality of life in those who became biochemically hypothyroid after GH replacement. The group at highest risk are those with organic pituitary disease or multiple pituitary hormone deficiencies. It is therefore prudent to monitor thyroid function in hypopituitary patients starting GH therapy to identify those who will develop clinical and biochemical features of central hypothyroidism, thus facilitating optimal and timely replacement.

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The influence of growth hormone monotherapy and growth hormone in combination with oxandrolone or testosterone on thyroxid hormone parameters and thyrxine binding globulin in patients with Ullrich- Turner syndrome

Abstract: The observed changes in thyroid hormone and TBG levels in the Ox group were not mediated by GH or IGF-I. The Ox-induced TBG decrease might be linked to altered pancreatic functions regulating carbohydrate metabolism.

Cited by 6 publications

References 23 publications

Growth hormone (GH) treatment reduces peripheral thyroid hormone action in girls with Turner syndrome

Growth hormone (GH) treatment reduces peripheral thyroid hormone action in girls with Turner syndrome

IGF-I Resistance and Turner's Syndrome

The interaction between growth hormone and the thyroid axis in hypopituitary patients

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