{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T22:42:39Z","timestamp":1706827359551},"reference-count":56,"publisher":"The Endocrine Society","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,8,1]]},"abstract":"<jats:p>The objectives of this study were to 1) study the GH-insulin-like growth factor (IGF) axis in adult untreated Turner\u2019s syndrome compared to that in age-matched controls, 2) examine the effects of sex hormone substitution on this axis, 3) study the effects of route of administration of 17\u03b2-estradiol on the measured variables, and 4) examine the effects of sex steroids on hepatic function in Turner patients. Twenty-seven patients with Turner\u2019s syndrome were evaluated before and during sex hormone replacement, and an age-matched control group (n = 24) was evaluated once. Main outcome variables were GH and other measures of the GH-IGF axis, body composition, maximal oxygen uptake, sex hormone-binding globulin, and hepatic enzymes and proteins.<\/jats:p>\n               <jats:p>The integrated 24-h GH concentration (IC-GH; micrograms per L\/24 h) was reduced in women with Turner\u2019s syndrome (T) compared to controls [C; mean \u00b1 sd, 18.3 \u00b1 12.0 (T) vs. 37.2 \u00b1 29.7 (C); P = 0.007]. However, multiple regression revealed that fat-free mass (FFM) and maximal oxygen uptake were significant explanatory variables (joint r = 0.77; P &amp;lt; 0.0005), accounting for 60% of the variance in the 24-h IC-GH. This association was also present in controls. After adjustment for these two variables, any difference in GH concentration between Turner patients and controls disappeared. Serum IGF-I and IGF-II were identical in Turner patients and controls despite the difference in 24-h IC-GH. The level of GH-binding protein (GHBP; nanomoles per L) was higher in Turner women [1.87 \u00b1 0.72 (T) vs. 1.22 \u00b1 0.33 (C); P = 0.0005]; after adjustment for FFM, the difference in GHBP levels disappeared between Turner patients and controls. During sex hormone treatment a significant increase was seen in the 24-h IC-GH (P = 0.02), FFM (percentage of weight; P &amp;lt; 0.0005) and maximal oxygen uptake (milliliters of O2 per kg\/min; P = 0.02). Serum IGF-I was unchanged, whereas serum IGF-II (micrograms per L) decreased significantly [Turner, basal (TB), vs. Turner, treatment (TT), 860 \u00b1 135 vs. 823 \u00b1 150; P = 0.04]. Alanine aminotransferase (units per L), \u03b3-glutamyl transferase (units per L), and alkaline phosphatase (units per L) were significantly elevated during the basal study period, and all decreased during treatment [alanine aminotransferase, 55 \u00b1 55 (TB) vs. 30\u00b1 20 (TT; P = 0.006); \u03b3-glutamyl transferase, 92 \u00b1 98 (TB) vs. 43 \u00b1 65 (TT; P = 0.003); alkaline phosphatase, 211 \u00b1 113 (TB) vs. 175\u00b1 54 (TT); P = 0.06]. The route of administration of 17\u03b2-estradiol did not affect its actions.<\/jats:p>\n               <jats:p>In conclusion, we found the GH-IGF axis in Turner\u2019s syndrome to be normal, with body composition and physical fitness exerting the same modifying effects on this axis as seen in the normal population. Sex hormone replacement in Turner\u2019s syndrome is associated with normalizing effects on the GH-IGF axis, body composition, physical fitness, and hepatic function. The lowering of hepatic enzymes is a surprising and hitherto undiscovered action of sex steroids. Finally, the route of administration of 17\u03b2-estradiol is of minor importance in Turner\u2019s syndrome.<\/jats:p>","DOI":"10.1210\/jcem.82.8.4127","type":"journal-article","created":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T17:02:30Z","timestamp":1389200550000},"page":"2570-2577","source":"Crossref","is-referenced-by-count":2,"title":["Body Composition and Physical Fitness Are Major Determinants of the Growth Hormone-Insulin-Like Growth Factor Axis Aberrations in Adult Turner\u2019s Syndrome, with Important Modulations by Treatment with 17\u03b2-Estradiol1"],"prefix":"10.1210","volume":"82","author":[{"given":"Claus H\u00f8jbjerg","family":"Gravholt","sequence":"first","affiliation":[{"name":"Medical Department M (Endocrinology and Diabetes) (C.H.G., S.F., J.S.C.), DK-8000 Aarhus C, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rune Weis","family":"Naeraa","sequence":"additional","affiliation":[{"name":"Pediatric Department A (R.W.N.), Aarhus University Hospital, Kommunehospitalet, DK-8000 Aarhus C, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanne","family":"Fisker","sequence":"additional","affiliation":[{"name":"Medical Department M (Endocrinology and Diabetes) (C.H.G., S.F., J.S.C.), DK-8000 Aarhus C, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens Sandahl","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Medical Department M (Endocrinology and Diabetes) (C.H.G., S.F., J.S.C.), DK-8000 Aarhus C, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071619332323400_R1","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1136\/adc.64.4.587","article-title":"Growth hormone secretion in Turner\u2019s syndrome and influence of oxandrolone and ethinyl oestradiol.","volume":"64","author":"Massarano","year":"1989","journal-title":"Arch Dis Child"},{"key":"2020071619332323400_R2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1530\/acta.0.1250038","article-title":"Decreased growth hormone response to growth hormone-releasing hormone in Turner\u2019s syndrome: relation to body weight and adiposity.","volume":"125","author":"Reiter","year":"1991","journal-title":"Acta Endocrinol (Copenh)"},{"key":"2020071619332323400_R3","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1210\/jcem-73-5-1073","article-title":"Decreased metabolic clearance of endogenous growth hormone and specific alterations in the pulsatile mode of growth hormone secretion occur in prepubertal girls with Turner\u2019s syndrome. 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