Background: Individuals with Turner syndrome (TS) are at increased risk for impaired glucose tolerance (IGT) and diabetes mellitus. It is unknown if pharmacological growth hormone (GH) treatment commonly used to treat short stature in TS alters this risk.

Objective: To compare adiposity and glucose tolerance in GH-treated vs. untreated girls with TS

Methods: In a cross sectional study, GH-treated girls with TS (n=76, age 13.6±3.7 yrs) were compared with girls with TS that never received GH (n=26, age 13.8±3.5 yrs). Protocol studies took place in the NIH CRC from 2001–2006 and included oral glucose tolerance tests, body composition analysis by DEXA and abdominal fat quantification by MRI. GH was not given during testing.

Results: Total body fat (35±8% vs. 28±8%, P<0.0001), subcutaneous abdominal fat (183 vs. 100 cc³, P=0.001) and intra-abdominal fat (50 vs. 33 cc³, P<0.0001) were significantly greater in untreated girls. Fasting glucose and insulin were similar but the response to oral glucose was significantly impaired in the untreated group (28% vs. 7% with IGT, P=0.006). A specific excess of visceral fat and insulin resistance was apparent only in post-pubertal girls that had never received GH. GH-treated girls demonstrated lower adiposity compared to untreated girls for an average of 2 years after discontinuation of GH.

Conclusions: Abdominal adiposity is significantly lower and glucose tolerance significantly better in GH-treated vs. untreated girls with TS, suggesting that beneficial effects upon body composition and regional fat deposition outweigh transient insulin antagonism associated with GH administration.