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Association of thyroid autoimmunity and the response to recombinant human growth hormone in Turner syndrome

By Yuyao Song, Hongbo Yang, Linjie Wang, Fengying Gong, Hui Pan, Huijuan Zhu

Posted 14 Sep 2020
medRxiv DOI: 10.1101/2020.09.13.20193573

Introduction: Short stature and thyroid autoimmunity are among the most common traits in Turner syndrome (TS). Recombinant human growth hormone (rhGH) treatment benefits height growth in Turner syndrome individuals when applicable. This study aims to investigate the association of thyroid autoimmunity and the response to rhGH treatment in Turner Syndrome patients. Methods: Medical records of 494 patients with TS were reviewed. Among 126 patients who regularly tested for thyroid autoantibodies, 108 patients had received rhGH treatment. Clinical characteristics, including karyotype and the presence of autoimmune thyroid diseases, as well as rhGH treatment records were analyzed. Height velocity (HV) of patients with or without thyroid autoimmunity was compared to assess the response to rhGH treatment. For patients who received rhGH treatment and positive for thyroid autoantibodies, height velocity before and after antibody presence was compared. Results: 45XO monosomy presented in 36% (176/496) of patients. 42.1% of patients (53/126) had elevated circulating anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). In 108 patients who received rhGH treatment, a negative correlation was found between circulating TPOAb concentration and HV (n=53, r = -0.276, P<0.05). For patients who developed thyroid autoantibodies during rhGH treatment, HVs after thyroid autoantibody presence significantly decreased compared with HVs before thyroid autoantibody detection (n=44, p=0.0017). Conclusions: Our data suggested that in preadult TS patients who developed thyroid autoantibodies during rhGH treatment, the response to rhGH is negatively associated with the development of thyroid autoimmunity.

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