porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2009119-22porozendo-4073Research ArticleСтатьиArticlesМинеральная плотность кости у девочек с синдромомШерешевского-Тернера в допубертатном возрасте ивлияние на нее терапии рекомбинантным гормономростаMineral'naya plotnost' kosti u devochek s sindromomShereshevskogo-Ternera v dopubertatnom vozraste ivliyanie na nee terapii rekombinantnym gormonomrostaVolevodzN. N.-PankratovaM. S.-SazonovaN. I.-200915122008121№1 (2009)1922Copyright © Volevodz N.N., Pankratova M.S., Sazonova N.I., 20092009Volevodz N.N., Pankratova M.S., Sazonova N.I.Volevodz N.N., Pankratova M.S., Sazonova N.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/4073

В настоящей работе изучено состояние минеральной плотности кости (МПК) в поясничном отделе позвоночника (L2-L4) у девочек с синдромом Шерешевского-Тернера (СШТ) в допубертатном возрасте, получавших и не получавших лечение рекомбинантным гормоном роста. В исследовании принимали участие 28 пациенток с СШТ в возрасте от 7,8 до 13,1 года. Из них 15 девочек в среднем в течение 1,5 года получали терапию рГР в дозе 0,05 мг/кг/сут., и 13 девочек не получали ранее ростстимулирующую терапию. При анализе МПК в группе I выявлена остеопения у 40% по паспортному и у 13% по костному возрасту. В группе II обнаружены как остеопения (у 38% по хронологическому и у 42% по костному возрасту), так и остеопороз (у 31% по хронологическому и у 8% по костному возрасту). В группе пациенток с СШТ, не получавших терапии, отмечалось более выраженное снижение МПК (Z-критерий = -1,44±1,2). У пациенток, получавших терапию гормоном роста, снижения МПК выявлено не было (Z-критерий = -0,79±0,13). Статистически значимое увеличение показателей МПК (p = 0,011), а также Z-критерия для хронологического (p = 0,023) и костного (p = 0,028) возраста в группе пациенток, получавших терапию гормоном роста, по сравнению с пациентками, не получавшими лечение, свидетельствует в пользу протективного влияния терапии гормоном роста на состояние костной ткани при СШТ.

синдром Шерешевского-Тернерарекомбинантный гормон ростаминеральная плотность костной тканиReferencesДедов И.И., Петеркова В.А., Волеводз Н.Н., Семичева Т.В. Синдром Шерешевского-Тернера (патогенез, клиника, диагностика, лечение): Методические рекомендации. Москва, 2002.Дедов И.И., Петеркова В.А., Волеводз Н.Н., Семичева Т.В. Синдром Шерешевского-Тернера (патогенез, клиника, диагностика, лечение): Методические рекомендации. Москва, 2002.American Association of Clinical Endocrinologists (AACE). American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in adults and children-2003 update. Endocr. Pract. 2003; 9(1): 64-76.American Association of Clinical Endocrinologists (AACE). American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in adults and children-2003 update. Endocr. Pract. 2003; 9(1): 64-76.Ari M., Bakalov V.K., S. Hill, and С.A. Bondy. The Effects of Growth Hormone Treatment on Bone Mineral Density and Body Composition in Girls with Turner Syndrome. J. Clin. Endocrinol. Metab., 2006; 91(11): 4302-4305.Ari M., Bakalov V.K., S. Hill, and С.A. Bondy. The Effects of Growth Hormone Treatment on Bone Mineral Density and Body Composition in Girls with Turner Syndrome. J. Clin. Endocrinol. Metab., 2006; 91(11): 4302-4305.Bakalov V.K., Axelrod L., Baron J., Hanton L., Nelson .LM., Reynolds J.C., Hill S., Troendle J., Bondy C.A. Selective reduction in cortical bone mineral density in Turner syndrome independent of ovarian hormone deficiency. J Clin Endocrinol Metab 2003; 88: 5717-5722Bakalov V.K., Axelrod L., Baron J., Hanton L., Nelson .LM., Reynolds J.C., Hill S., Troendle J., Bondy C.A. Selective reduction in cortical bone mineral density in Turner syndrome independent of ovarian hormone deficiency. J Clin Endocrinol Metab 2003; 88: 5717-5722Bakalov V.K., Van P.L., Baron J., Reynolds J.C., Bondy C.A. Growth hormone therapy and bone mineral density in Turner syndrome. J Clin Endocrinol Metab 2004; 89: 4886-488.Bakalov V.K., Van P.L., Baron J., Reynolds J.C., Bondy C.A. Growth hormone therapy and bone mineral density in Turner syndrome. J Clin Endocrinol Metab 2004; 89: 4886-488.Betts P.R., Butler G.E., Donaldson C. A decade of growth hormone treatment in girls with Turner syndrome in the UK. Arch Dis Child 1999; 80 (3): 221-225.Betts P.R., Butler G.E., Donaldson C. A decade of growth hormone treatment in girls with Turner syndrome in the UK. Arch Dis Child 1999; 80 (3): 221-225.Carel J.C., Mathivon L., Gendrel C., Ducret J.P., Chaussain J.L. Near normalization of fnal height with adapted doses of growth hormone in Turner's syndrome. J Clin Endocrinol Metab 1998; 83: 1462-1466Carel J.C., Mathivon L., Gendrel C., Ducret J.P., Chaussain J.L. Near normalization of fnal height with adapted doses of growth hormone in Turner's syndrome. J Clin Endocrinol Metab 1998; 83: 1462-1466Carrascosa A., Gussinye M., Terradas P., Yeste D., Audi L., Vicens-Calvet E. Spontaneous, but not induced, puberty permits adequate bone mass acquisition in adolescent Turner syndrome patients. J Bone Miner Res 2000; 15: 2005-2010.Carrascosa A., Gussinye M., Terradas P., Yeste D., Audi L., Vicens-Calvet E. Spontaneous, but not induced, puberty permits adequate bone mass acquisition in adolescent Turner syndrome patients. J Bone Miner Res 2000; 15: 2005-2010.Chernausek S.D., Attie K.M., Cara J.F., Rosenfeld R.G. Growth Hormone Therapy of Turner Syndrome: The Impact of Age of Estrogen Replacement on Final Height. J Clin Endocrinol Metabоl 2000; 85 (7): 2439-2445.Chernausek S.D., Attie K.M., Cara J.F., Rosenfeld R.G. Growth Hormone Therapy of Turner Syndrome: The Impact of Age of Estrogen Replacement on Final Height. J Clin Endocrinol Metabоl 2000; 85 (7): 2439-2445.Elsheikh M., Dunger D.B., Conway G.S., and Wass J.A. Turner's Syndrome in Adulthood. Endocr Rev 2002; 23 (1): 120-140.Elsheikh M., Dunger D.B., Conway G.S., and Wass J.A. Turner's Syndrome in Adulthood. Endocr Rev 2002; 23 (1): 120-140.Gravholt C.H. Epidemiological, endocrine and metabolic features in Turner syndrome. Europ. J Endocrinol 2004; 151: 657-687.Gravholt C.H. Epidemiological, endocrine and metabolic features in Turner syndrome. Europ. J Endocrinol 2004; 151: 657-687.Greulich W.W., Pyle S.I. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. Stanford: Stanford University Press, 1959.Greulich W.W., Pyle S.I. Radiographic atlas of skeletal development of the hand and wrist, 2nd ed. Stanford: Stanford University Press, 1959.Hochberg Z., Zadik Z. Final height in young women with Turner syndrome after GH therapy: an open controlled study. Europ. J Endocrinol 1999; 141: 218-224.Hochberg Z., Zadik Z. Final height in young women with Turner syndrome after GH therapy: an open controlled study. Europ. J Endocrinol 1999; 141: 218-224.Lanes R., Gunczler P., Esaa S., Weisinger J.R. The effect of short-and long-term growth hormone treatment on bone mineral density and bone metabolism of prepubertal children with idiopathic short stature: a 3-year study. Clin Endocrinol (Oxf) 2002; 57: 725-730.Lanes R., Gunczler P., Esaa S., Weisinger J.R. The effect of short-and long-term growth hormone treatment on bone mineral density and bone metabolism of prepubertal children with idiopathic short stature: a 3-year study. Clin Endocrinol (Oxf) 2002; 57: 725-730.Monson J.P., Drake W.M., Carroll P.V., Weaver J.U., Rodriguez-Arnao J., Savage M.O. Infuence of growth hormone on accretion of bone mass. Horm Res 2002; 58: 52-56.Monson J.P., Drake W.M., Carroll P.V., Weaver J.U., Rodriguez-Arnao J., Savage M.O. Infuence of growth hormone on accretion of bone mass. Horm Res 2002; 58: 52-56.Neely E.K., Marcus R., Rosenfeld R.G., Bachrach L.K. Turner syndrome adolescents receiving growth hormone are not osteopenic. J Clin Endocrinol Metab 1993; 76: 861-866.Neely E.K., Marcus R., Rosenfeld R.G., Bachrach L.K. Turner syndrome adolescents receiving growth hormone are not osteopenic. J Clin Endocrinol Metab 1993; 76: 861-866.Rosenfeld R.G., Attie K.M., Frane .J, et al Growth hormone therapy of Turner's syndrome: benefcial effect on adult height. J Pediatr 1998; 132: 319-324.Rosenfeld R.G., Attie K.M., Frane .J, et al Growth hormone therapy of Turner's syndrome: benefcial effect on adult height. J Pediatr 1998; 132: 319-324.Sas T.C., de Muinck Keizer-Schrama S.M., Stijnen T., van Teunenbroek A., van Leeuwen W.J., Asarf A., van Rijn R.R., Drop S.L. Bone mineral density assessed by phalangeal radiographic absorptiometry before and during long-term growth hormone treatment in girls with Turner's syndrome participating in a randomized dose-response study. Pediatr Res 2001; 50: 417-422.Sas T.C., de Muinck Keizer-Schrama S.M., Stijnen T., van Teunenbroek A., van Leeuwen W.J., Asarf A., van Rijn R.R., Drop S.L. Bone mineral density assessed by phalangeal radiographic absorptiometry before and during long-term growth hormone treatment in girls with Turner's syndrome participating in a randomized dose-response study. Pediatr Res 2001; 50: 417-422.Shaw N.J., Rehan V.K., Husain S., Marshall T., Smith C.S. Bone mineral density in Turner's syndrome: a longitudinal study. Clin Endocrinol (Oxf) 1997; 47: 367-370.Shaw N.J., Rehan V.K., Husain S., Marshall T., Smith C.S. Bone mineral density in Turner's syndrome: a longitudinal study. Clin Endocrinol (Oxf) 1997; 47: 367-370.Suganuma N., Furuhashi M., Hirooka T., Moriwaki T., Hasegawa Y., Mori O., Ogawa M. Bone mineral density in adult patients with Turner's syndrome: analyses of the effectiveness of GH and ovarian steroid hormone replacement therapies. Endocr. J 2003; 50: 263-269.Suganuma N., Furuhashi M., Hirooka T., Moriwaki T., Hasegawa Y., Mori O., Ogawa M. Bone mineral density in adult patients with Turner's syndrome: analyses of the effectiveness of GH and ovarian steroid hormone replacement therapies. Endocr. J 2003; 50: 263-269.Tanner J.M., Whitehouse R.H., Takaishi M. Standards from birth to maturity for height, height velocity and weight velocity: British children, 1965 Part II. Arch Dis Child 1966; 41: 613-635.Tanner J.M., Whitehouse R.H., Takaishi M. Standards from birth to maturity for height, height velocity and weight velocity: British children, 1965 Part II. Arch Dis Child 1966; 41: 613-635.Tanner J.M., Whitehouse R.H Clinical longitudinal standard for height, weight, height velocity, weight velocity and stages of puberty. Arch Dis Child 1976; 51: 170-171.Tanner J.M., Whitehouse R.H Clinical longitudinal standard for height, weight, height velocity, weight velocity and stages of puberty. Arch Dis Child 1976; 51: 170-171.The Turner Syndrome Consensus Study Group Care of Girls and Women with Turner Syndrome: A Guideline of theTurner Syndrome Study Group. J Clin Endocrin Metab 2006; (10): 1310-1374.The Turner Syndrome Consensus Study Group Care of Girls and Women with Turner Syndrome: A Guideline of theTurner Syndrome Study Group. J Clin Endocrin Metab 2006; (10): 1310-1374.

The authors declare that there are no conflicts of interest present.