Metabolic syndrome in Turner syndrome and relation between body composition and clinical, genetic, and ultrasonographic characteristics.
BACKGROUND
An increased relative risk of diabetes, ischemic heart disease, atherosclerosis, and hypertension have been reported in Turner syndrome (TS) patients. No data are currently available on the prevalence of metabolic syndrome in TS subjects. We evaluated the frequency of metabolic syndrome in obese and nonobese patients with TS.


METHODS
We evaluated 85 TS patients (27.05 ± 11.17 years). Obesity was defined as standard deviation score body mass index (SDS-BMI) ≥ 2 or BMI ≥ 30 kg/m(2) in adult patients. We classified metabolic syndrome according to the International Diabetes Federation (IDF). Hepatic ultrasound was performed in all girls.


RESULTS
The prevalence of metabolic syndrome was 4.7% (12.5% obese and 4.3% nonobese, P=0.16) and associated with visceral adiposity (P=0.008). Abnormalities in glucose metabolism and hypertension were not associated with genetic or therapeutic factors. The karyotype 45,X was associated with atherogenic profile. Pathological waist circumference was more frequent in girls treated with estro-progestin (P=0.03). Evidence of fatty liver was associated with metabolic syndrome (P=0.03) and insulin resistance (P=0.05). Elevated liver enzymes were found in 15 subjects and were not related to treatment or ultrasound abnormalities.


CONCLUSIONS
Prevalence of each component of metabolic syndrome in TS patients is partially influenced by genetic makeup and treatment. Hepatosteatosis was associated with metabolic syndrome and insulin resistance, but not to elevated liver enzymes.
1 Department of Internal Medicine University of Pavia and Department of the Mother and Child Health , Pediatric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy .
Valeria
V
Calcaterra
Paola
P
Brambilla
Gabriella Carnevale
GC
Maffè
Catherine
C
Klersy
Riccardo
R
Albertini
Francesca
F
Introzzi
Elena
E
Bozzola
Mauro
M
Bozzola
Daniela
D
Larizza
D000293:Adolescent; D000328:Adult; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002648:Child; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000235:genetics; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics; D015995:Prevalence; D017678:Sex Distribution; D014424:Turner Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000235:genetics; D014463:Ultrasonography; D055105:Waist Circumference; D055815:Young Adult
D005947:Glucose