A Prospective Study of Lipids in Adult Women With Turner Syndrome

Kristian Juul Sandahl; Jesper Just; Mogens Erlandsen; Kristian Havmand Mortensen; Niels Holmark Andersen; Claus Højbjerg Gravholt

doi:10.1210/jendso/bvad124

A Prospective Study of Lipids in Adult Women With Turner Syndrome

J Endocr Soc. 2023 Sep 29;7(11):bvad124. doi: 10.1210/jendso/bvad124. eCollection 2023 Oct 9.

Authors

Kristian Juul Sandahl^{1

2}, Jesper Just^{2

3}, Mogens Erlandsen², Kristian Havmand Mortensen⁴, Niels Holmark Andersen⁵, Claus Højbjerg Gravholt^{1

2

3}

Affiliations

¹ Department of Endocrinology, Aarhus University Hospital, Aarhus N 8200, Denmark.
² Department of Clinical Medicine, Aarhus University, Aarhus N 8200, Denmark.
³ Department of Molecular Medicine, Aarhus University Hospital, Aarhus N 8200, Denmark.
⁴ Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.
⁵ Department of Cardiology, Aalborg University Hospital, Aalborg 9000, Denmark.

Abstract

Context: Turner syndrome (TS) is a rare genetic syndrome with an increased mortality, mainly attributed to cardiovascular disease.

Objective: This work aimed to investigate and correlate the lipid profile in adult women with TS to clinical characteristics.

Methods: A 12-year prospective cohort study, including 4 study visits, was conducted at a specialist hospital. A total of 102 women with TS qualified for inclusion. Excluding missing variables and participants lost to follow-up, 86 women (mean age 38.1 years; range, 18.4-62.1 years) were included in this study. Fifty-three women completed the study. Repeated-measurement analysis was performed, using total cholesterol (Total-C), low-density lipoprotein (LDL), triglycerides (TGs), and high-density lipoprotein (HDL) as outcome variables and age, karyotype, body mass index (BMI), treatment with statins, antidiabetics, and hormone replacement therapy as explanatory variables. Principal component analysis (PCA) and partial least squares (PLS) analysis were performed at the first study visit.

Results: Hyperlipidemia was present in 30% of the TS cohort. Total-C increased with age (0.12 mmol/L/y; P = .016). LDL (P = .08), TGs (P = .14), and HDL (P = .24) were not associated with age. BMI significantly increased total-C (0.19 mmol/L/kg/m²; P = .006), LDL (0.63 mmol/L/kg/m²; P < .001), and TGs (0.80 mmol/L/kg/m²; P < .001) and decreased HDL (-0.59 mmol/L/kg/m²; P < .001). PCA and PLS analysis found correlations between weight and BMI and total-C, LDL, and TGs.

Conclusion: Hyperlipidemia is more prevalent in adult women with TS across adulthood compared to the background population. Total-C, LDL, TGs, and HDL were significantly associated with BMI characterizing the atherogenic profile in adult women with TS.

Keywords: Turner syndrome; cardiometabolic; hypercholesterolemia; hyperlipidemia; metabolic syndrome.