Metabolic and cardiovascular outcomes in a group of adult patients with Turner's syndrome under hormonal replacement therapy

Eur J Endocrinol. 2011 May;164(5):819-26. doi: 10.1530/EJE-11-0002. Epub 2011 Mar 4.

Abstract

Objective: Turner's syndrome (TS) is a rare genetic disorder caused by complete or partial X chromosome monosomy in a phenotypic female, and it is associated with increased morbidity and mortality for cardiovascular diseases, impaired glucose tolerance, and dyslipidemia.

Subjects and methods: In 30 adult TS patients under chronic hormonal replacement therapy (HRT), 17β-estradiol (E(2)), body mass index (BMI), waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test (OGTT), 24 h ambulatory blood pressure monitoring (ABPM), and intima-media thickness (IMT) were evaluated and compared with those in 30 age- and sex-matched controls (CS).

Results: No difference was found between TS and CS in E(2) and BMI, whereas waist circumference was higher (P<0.05) in TS (77.7±2.5 cm) than in CS (69.8±1.0 cm). Fasting glucose in TS and in CS was similar, whereas fasting insulin, HOMA index, and 2 h glucose after OGTT were higher (P<0.0005) in TS (13.2±0.8 mUI/l, 2.5±0.2, and 108.9±5.5 mg/dl respectively) than in CS (9.1±0.5 mUI/l, 1.8±0.1, and 94.5 ± 3.8 mg/dl respectively). Total cholesterol was higher (P<0.05) in TS (199.4 ± 6.6 mg/dl) than in CS (173.9±4.6 mg/dl), whereas no significant differences in high-density lipoprotein, low-density lipoprotein, and triglycerides were found between the two groups. In 13% of TS, ABPM showed arterial hypertension, whereas IMT was <0.9 mm in all TS and CS. A negative correlation between insulin levels, HOMA index, or 2 h glucose after OGTT and E(2) was present in TS.

Conclusions: Our results indicate that adult patients with TS under HRT are connoted by higher frequency of central obesity, insulin resistance, hypercholesterolemia, and hypertension.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / metabolism*
  • Estradiol / adverse effects*
  • Estrogen Replacement Therapy / adverse effects*
  • Female
  • Humans
  • Hypercholesterolemia / chemically induced
  • Hypercholesterolemia / metabolism
  • Hypertension / chemically induced
  • Hypertension / metabolism
  • Insulin Resistance / physiology
  • Obesity / chemically induced
  • Obesity / metabolism
  • Treatment Outcome
  • Turner Syndrome / drug therapy*
  • Turner Syndrome / metabolism*
  • Waist Circumference / drug effects
  • Waist Circumference / physiology

Substances

  • Blood Glucose
  • Estradiol