Quality of life after growth hormone therapy and induced puberty in women with Turner syndrome

Objective To evaluate health-related quality of life (HRQoL) in young women with Turner syndrome ITS) after long-term growth hormone (GH) therapy and induced puberty and to analyze whether HRQoL was influenced by auxologic parameters, pubertal development, or subjective parameters. Study design The study group comprised 49 women with TS, mean (standard deviation) age 19.6 ( +/- 3.0) years, all former participants of 2 GH studies, 6 months after GH discontinuation. Puberty was induced by estrogen treatment, at mean age 12.9 ( +/- 1.1) years. HRQoL was measured by self-reports of the 2 generic questionnaires, SF36 and TAAQOL. As an additional source of information on HRQoL, we applied parental proxy reports. Results HRQoL of the women with TS was normal. Remarkably, the women with TS had higher HRQoL scores on some of the scales, including "social functioning" and "role-emotional." Satisfaction with height and breast development had a positive influence on several HRQoL scales. Conclusions The young women with TS who reached normal height and had age-appropriate pubertal development reported normal HRQoL. The relatively high scores on some of the HRQoL scales can be explained by an estrogen effect or by a possible response shift, indicating a different internal reference in women with TS. We hypothesize that GH and estrogen treatment positively influenced HRQoL in young women with TS.