Frequencies of spontaneous breast development and spontaneous menarche in Turner syndrome in Japan

Toshiaki Tanaka; Yutaka Igarashi; Keiichi Ozono; Kenji Ohyama; Masamichi Ogawa; Hisao Osada; Kazumichi Onigata; Susumu Kanzaki; Hitoshi Kohno; Yoshiki Seino; Hiroaki Takahashi; Toshihiro Tajima; Katsuhiko Tachibana; Hiroyuki Tanaka; Yoshikazu Nishi; Tomonobu Hasegawa; Keinosuke Fujita; Tohru Yorifuji; Reiko Horikawa; Susumu Yokoya

doi:10.1297/cpe.24.167

Frequencies of spontaneous breast development and spontaneous menarche in Turner syndrome in Japan

Clin Pediatr Endocrinol. 2015 Oct;24(4):167-73. doi: 10.1297/cpe.24.167. Epub 2015 Oct 24.

Authors

Toshiaki Tanaka¹, Yutaka Igarashi², Keiichi Ozono³, Kenji Ohyama⁴, Masamichi Ogawa⁵, Hisao Osada⁶, Kazumichi Onigata⁷, Susumu Kanzaki⁸, Hitoshi Kohno⁹, Yoshiki Seino¹⁰, Hiroaki Takahashi¹¹, Toshihiro Tajima¹², Katsuhiko Tachibana¹³, Hiroyuki Tanaka¹⁴, Yoshikazu Nishi¹⁵, Tomonobu Hasegawa¹⁶, Keinosuke Fujita¹⁷, Tohru Yorifuji¹⁸, Reiko Horikawa¹⁹, Susumu Yokoya¹⁹

Affiliations

¹ Tanaka Growth Clinic, Tokyo, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
² Igarashi Children's Clinic, Sendai, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
³ Osaka University, Osaka, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁴ University of Yamanashi, Kofu, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁵ Ogawa Clinic, Nagoya, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁶ J.F. Oberlin University, Machida, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁷ Shimane University Faculty of Medicine, Izumo, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁸ Tottori University Faculty of Medicine, Yonago, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
⁹ Fukuoka Children's Hospital, Fukuoka, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan ; Present: Fukuoka Tokushukai Hospital, Kasuga, Japan.
¹⁰ JCHO Osaka Hospital, Osaka, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹¹ Chiba City Ryoiku Center, Chiba, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹² Hokkaido University School of Medicine, Sapporo, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹³ JCR Pharmaceuticals Co., Ltd., Ashiya, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁴ Okayama Saiseikai General Hospital, Okayama, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁵ Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁶ Keio University, Tokyo, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁷ Osaka City University, Osaka, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁸ Osaka City General Hospital, Osaka, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.
¹⁹ National Center for Child Health and Development, Tokyo, Japan ; Turner Syndrome Research Collaboration, Tokyo, Japan.

Abstract

The Growject® database on human GH treatment in Turner syndrome was analyzed in the Turner Syndrome Research Collaboration, and the relationships of the frequencies of spontaneous breast development and spontaneous menarche with karyotype and GH treatment were investigated. One hundred and three cases started GH treatment with 0.5 IU/kg/ week (0.5 IU group), and their dose was increased to 0.35 mg/kg/wk midway through the treatment course. Another 109 cases started GH at a dose of 0.35 mg/kg/wk (0.35 mg group). Spontaneous breast development was observed in 77 (36.3%) of the 212 patients, and spontaneous menarche occurred in 31 patients (14.6%). The frequency of spontaneous breast development was significantly lower in patients with the 45,X karyotype and significantly higher in patients with a structural abnormality of the second X chromosome. The frequency of spontaneous menarche was significantly higher in patients with mosaicism characterized by X monosomy and a cellular line with no structural abnormality of the X chromosome. No significant differences in frequencies of spontaneous breast development and spontaneous menarche were observed between the two dose groups, indicating that GH treatment does not increase the frequency of spontaneous puberty.

Keywords: GH treatment; Turner syndrome; chromosome; spontaneous breast development; spontaneous menarche.