{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:09:31Z","timestamp":1775797771164,"version":"3.50.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Turner syndrome (TS) is a lifelong chromosomal disorder characterized by short stature, gonadal dysgenesis, and multisystem comorbidities. This study presents a 25-year singlecenter experience, evaluating growth outcomes\u2014including the impact of growth hormone (GH) initiation age\u2014pubertal development, comorbidity burden, and transition patterns from pediatric to adult care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 31 TS patients followed between 1996 and 2021. Clinical, anthropometric, and laboratory data at diagnosis, during follow-up, and at the most recent visit were collected using structured forms. Karyotype, GH treatment history, final height, pubertal status, systemic comorbidities, and adult follow-up outcomes were analyzed. Adult TS patients were re-evaluated using a standardized adult TS assessment form. Final height outcomes were compared across GH initiation age groups (\u22646 y, 6\u201312 y, \u226512 y). Continuous variables were assessed for normality and compared using ANOVA or Kruskal\u2013Wallis tests, as appropriate. Multivariable linear regression analysis was performed to evaluate independent predictors of final height standard deviation score (SDS). Categorical variables were summarized descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 31 patients (current age range: 1.5\u201338 years); 32% had classical 45, X and 68% mosaic karyotypes. Twenty-three patients received GH therapy, with a mean initiation age of 7.4 \u00b1 4.1 years. Mean final height was 155.7 \u00b1 6.8\u00a0cm. Patients who initiated GH therapy at \u22646 years achieved higher final heights (approximately 159\u2013163 cm) compared with those initiating at \u226512 years (approximately 140\u2013156 cm). In multivariable analysis, earlier GH initiation showed a trend toward association with improved final height SDS. Multisystem comorbidities were frequent and, in descending order of prevalence, included renal anomalies (41%), cardiovascular abnormalities (35%), hearing impairment (34%), ophthalmologic disorders (32%), autoimmune disease (29%), and metabolic disorders (25%). Among adult patients who transitioned to adult care (n = 13), only one maintained regular endocrinology follow-up, and none completed recommended aortic surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early GH initiation yields final height outcomes comparable to the most favorable international cohorts. Turner syndrome requires lifelong, multidisciplinary follow-up, yet major gaps persist during transition to adult care. Strengthening structured transition pathways is essential to optimize long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1771065","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:27:40Z","timestamp":1775795260000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Turner syndrome across the lifespan: a 25-year single-center experience from neonatal diagnosis to adult outcomes"],"prefix":"10.3389","volume":"17","author":[{"given":"Aysegul","family":"Ceran","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirmen","family":"K\u0131z\u0131lcan \u00c7etin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeynep","family":"\u015e\u0131klar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif","family":"\u00d6zsu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merih","family":"Berbero\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zehra","family":"Aycan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University Faculty of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/eje-17-0430","article-title":"Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting","volume":"177","author":"Gravholt","year":"2017","journal-title":"Eur J Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"G53","DOI":"10.1530\/endoabs.49.gs1.1","article-title":"Clinical practice guidelines for the care of girls and women with Turner syndrome","volume":"190","author":"Gravholt","year":"2024","journal-title":"Eur J Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02807.x","article-title":"Chromosomal mosaicism mitigates stigmata and cardiovascular risk factors in Turner syndrome","volume":"66","author":"El-Mansoury","year":"2007","journal-title":"Clin Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.118.011501","article-title":"Long-term outcomes in patients with Turner syndrome: a 68-year follow-up","volume":"8","author":"Fuchs","year":"2019","journal-title":"JAHA"},{"key":"B5","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1002\/ajmg.a.30911","article-title":"Turner syndrome: Four challenges across the lifespan","author":"Sutton","year":"2005","journal-title":"Am J Med Genet Part A"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1530\/ec-24-0477","article-title":"Prevalence and management of hypertension in Turner syndrome: data from the International Turner Syndrome (I-TS) registry","volume":"14","author":"Diddhenipothage","year":"2025","journal-title":"Endocrine Connections"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpaf026","article-title":"Elevated blood pressure and cardiac mechanics in children and adolescents: a systematic review and meta-analysis","volume":"38","author":"Faggiano","year":"2025","journal-title":"Am J Hypertens"},{"key":"B8","article-title":"Growth and puberty in Turner\u2019s syndrome","volume":"16","author":"Bertelloni","year":"2003","journal-title":"J Pediatr Endocrinol Metabolism: JPEM"},{"key":"B9","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1093\/hmg\/9.5.695","article-title":"The short stature homeobox gene SHOX is involved in skeletal abnormalities in Turner syndrome","volume":"9","author":"Clement-Jones","year":"2000","journal-title":"Hum Mol Genet"},{"key":"B10","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1186\/s13023-022-02423-5","article-title":"Turner syndrome: French national diagnosis and care protocol (NDCP; national diagnosis and care protocol)","volume":"17","author":"Fiot","year":"2022","journal-title":"Orphanet J Rare Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"183","DOI":"10.4274\/jcrpe.2023","article-title":"Growth curves for Turkish girls with turner syndrome: Results of the Turkish turner syndrome study group","volume":"7","author":"Darendeliler","year":"2015","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.10.932","article-title":"Growth curve for girls with Turner syndrome","volume":"60","author":"Lyon","year":"1985","journal-title":"Arch Dis Childhood"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(98)70452-4","article-title":"Growth hormone therapy of Turner\u2019s syndrome: beneficial effect on adult height","volume":"132","author":"Rosenfeld","year":"1998","journal-title":"J Pediatr"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1159\/000515875","article-title":"Safety and effectiveness of recombinant human growth hormone in children with Turner syndrome: Data from the PATRO Children Study","volume":"94","author":"Backeljauw","year":"2021","journal-title":"Hormone Res Paediatrics"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(95)70161-3","article-title":"Final height after long-term growth hormone treatment in Turner syndrome","volume":"127","author":"Van den Broeck","year":"1995","journal-title":"J Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S46","DOI":"10.1203\/00006450-199305001-00258","article-title":"Three year efficacy results of a placebo-controlled to dose response study of human growth hormone in Turner\u2019s syndrome","volume":"33","author":"Chipman","year":"1993","journal-title":"Pediatr Res"},{"key":"B17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12958-015-0055-7","article-title":"Reproductive and obstetric outcomes in mosaic Turner\u2019s syndrome: a cross-sectional study and review of the literature","volume":"13","author":"Do\u011fer","year":"2015","journal-title":"Reprod Biol Endocrinol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1771065\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:27:42Z","timestamp":1775795262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1771065\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":17,"alternative-id":["10.3389\/fendo.2026.1771065"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1771065","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1771065"}}