Diabetes mellitus and Turner syndrome.
Noninsulindependent diabetes mellitus is 2-4 times more prevalent in Turner subjects as compared to normal females, and tends to develop at a younger age, but it is usually mild and responsive to weight loss or monotherapy. The primary pathogenic event is beta cell dysfunction, but insulin resistance also plays a central role and is worsened by the presence of hypertension, obesity and dyslipidemia which are common in Turner syndrome. We present the case of a 30 year-old female patient with short stature, 141cm (<-- 2.5 SD), overweight 51kg, waist circumference 79cm, triangular facies, downslanting palpebral fissures, low set ears, short neck, secondary amenorrhea, palpitations, a history of polyuria, polydypsia of three months duration and a fasting morning glucose of 260 mg/dL. Cardiac and renal defects were excluded, hormonologic evaluation was consistent with hypergonadotropic hypogonadism (FSH 65 mUI/mL) and primary hypothyroidism (TSH 5.68 microUI/mL) and karyotype was 45,XO. She also had hypercholesterolemia (247 mg/dL), hypocalcemia (8 mg/dL), mild elevation of hepatic enzymes (ALAT 51 U/L) and osteopenia (Tscore--2.22). Glycaemic control was achieved with diet only; therapy consisted of hormone replacement theraphy, thyroxine and beta blockers.
Lichiardopol
Corina
C
Dept of Endocrinology, University of Medicine and Pharmacy Craiova, Romania. corinalich@gmail.com
Moţa
Maria
M
Braicu
Daniela
D
Militaru
C
C
Mixich
F
F
D000328:Adult; D005117:Cardiac Complexes, Premature / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007621:Karyotyping; D014424:Turner Syndrome / Q000453:epidemiology* / Q000503:physiopathology