부산대학교 도서관

Background: Adult women with Turner syndrome (TS) have high rates of miscarriage, presumably due to the abnormal size and shape of the uterus. There is a paucity of data regarding the determinants of uterine volume (UtVol) in young girls with TS before the initiation of oestrogen replacement therapy (ERT). Methods: We performed a cross‐sectional study on premenarchal girls with TS, aged 5–15 years, pubertal stage B1–B3, not having received ERT (n = 73) and 50 age‐matched healthy controls. Anthropometric parameters and a history of growth hormone (GH) therapy (≥1 year) were noted. Uterine length (UtL), UtVol, and mean‐ovarian‐volume (MOV) standard‐deviation scores (SDS) were determined from transabdominal ultrasonography data. Results: Girls with TS had lower median UtVol‐SDS (−1.07 vs. 0.86; p <.001), UtL‐SDS (−3.72 vs. −0.41; p <.001) and MOV‐SDS (−5.53 vs. 1.96; p <.001) compared to age‐matched controls. Among TS girls, recipients of GH (n = 38) had higher UtVol‐SDS (−0.63 vs. −1.39; p =.0001), UtL‐SDS (−1.73 vs. −6.49; p <.0001) but similar MOV‐SDS compared to nonrecipients (n = 35). Those with normal uterine volume for age (NUVA, n = 29) had earlier initiation (7.8 vs. 9.3 years; p =.03) and a longer duration of GH (3.71 vs. 2.14 years; p =.002) than those with low UtVol for age (n = 44). UtVol‐SDS correlated with duration of GH (ρ = 0.411, p =.01) and negatively with age at GH initiation (ρ = −0.479, p =.003). In a model adjusted for pubertal status, karyotype and height‐SDS, GH use could independently predict having NUVA (odds ratio: 5.09, confidence interval: 1.63–15.94, p =.005). Conclusion: GH therapy has a stimulatory effect on uterine dimensions in pre‐and peripubertal girls with TS. Earlier initiation and longer duration of GH is important in TS girls before ERT. [ABSTRACT FROM AUTHOR]