title: Increased arterial stiffness in young normotensive patients with Turner syndrome: associations with vascular biomarkers.
abstract: OBJECTIVE
  Factors contributing to arteriopathy in patients with Turner syndrome (TS) remain unclear. We assessed arterial stiffness in young, normotensive patients with TS and correlated arterial stiffness with vascular biomarkers, GH treatment and oestrogen exposure. Sixty-one patients with TS (mean age, 12·6 years; range 6·6-21·3 years) were matched for age and sex with 61 healthy peers. Associations between arterial stiffness and high-sensitivity C-reactive protein (hsCRP), B-type natriuretic peptide (BNP), atrial NP (ANP), plasma aldosterone/plasma renin activity (PRA), IGF1 and IGFBP3 were examined after adjusting for well-established confounders of vascular disease.
  
  
  RESULTS
  Carotid intima media thickness standard deviation score (SDS), arterial stiffness index SDS and incremental modulus of elasticity SDS were higher, and distensibility coefficient SDS was lower in patients with TS. The duration of GH treatment and oestrogen exposure was not associated with indices of arterial stiffness. TS patients had higher hsCRP, BNP and ANP. Plasma aldosterone/PRA, IGF1 and IGFBP3 were similar in patients and controls. Multivariable regression analyses (R(2) = 0·200-0·668, P < 0·01) showed that BNP was associated with all indices of arterial stiffness. We found that hsCRP was associated with distensibility coefficient SDS (β = -0·16, P < 0·01). TS was independently associated with increased arterial stiffness (β = 0·420-3·424, P < 0·001 for all, R(2) = 0·06-0·31).
  
  
  CONCLUSIONS
  Young, normotensive TS patients had increased arterial stiffness than that of healthy peers. BNP, and possibly hsCRP, was independently associated with arterial stiffness in TS. Further research will determine any causal inference of these relationships.
authors.affiliation: Paediatric Endocrine Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Uçar
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Öz
authors.forename: Firdevs
authors.initials: F
authors.lastname: Baş
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Kemal
authors.initials: K
authors.lastname: Nişli
authors.forename: Melike
authors.initials: M
authors.lastname: Tuğrul
authors.forename: Aylin
authors.initials: A
authors.lastname: Yetim
authors.forename: Feyza
authors.initials: F
authors.lastname: Darendeliler
authors.forename: Nurçin
authors.initials: N
authors.lastname: Saka
authors.forename: Şükran
authors.initials: Ş
authors.lastname: Poyrazoğlu
authors.forename: Rüveyde
authors.initials: R
authors.lastname: Bundak
mesh_terms: D000293:Adolescent; D000328:Adult; D000450:Aldosterone / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D002648:Child; D004548:Elasticity; D005260:Female; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007621:Karyotyping; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012083:Renin / Q000097:blood; D014424:Turner Syndrome / Q000097:blood* / Q000473:pathology*; D059289:Vascular Stiffness; D055815:Young Adult
chemical_list: D015415:Biomarkers; C583557:IGF1 protein, human; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D020097:Natriuretic Peptide, Brain; D000450:Aldosterone; D007334:Insulin-Like Growth Factor I; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein; D012083:Renin