title: Low myocardial glucose uptake in Turner syndrome is unaffected by growth hormone: a randomized, placebo-controlled FDG-PET study.
abstract: BACKGROUND
  An unfavourable cardiovascular and metabolic phenotype causes threefold excess mortality in Turner syndrome (TS), and perturbed cardiac substrate metabolism is increasingly recognized as a common component of cardiovascular and metabolic diseases. We therefore hypothesized that myocardial glucose uptake (MGU) is reduced in TS and that growth hormone (GH) treatment improves MGU. To this end, this controlled trial elucidates MGU in TS and the impact of 6 months of growth hormone treatment on MGU.
  
  
  RESULTS
  Women with TS (n = 9) were examined at baseline, sequentially treated with either Norditropin(®) SimpleXx or placebo and re-examined after 6 months. MGU and myocardial blood flow (MBF) were measured using 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) during a hyperinsulinaemic euglycaemic clamp (at baseline and 6 months). Blood pressure measurement, blood sampling, echocardiography and dual energy X-ray absorptiometry scan were also performed. Age-matched female controls (n = 9) were examined once. Baseline MGU was reduced in TS (0.24 ± 0.08 vs. 0.36 ± 0.13 μmol/g/min in controls; P = 0.036) despite similar insulin sensitivity (whole body glucose uptake (M-value): 9.69 ± 1.86 vs. 9.86 ± 2.58 mg/(min*kg) in controls; P = 0.9). Six months of GH carried no impact on MGU (0.25 ± 0.08 vs. 0.26 ± 0.12 μmol/g/min in the placebo group; P = 0.8). Plasma glucose, low-density cholesterol and triglycerides increased, while M-value and exercise capacity decreased during 6 months of GH treatment.
  
  
  CONCLUSIONS
  MGU is reduced in TS despite normal insulin sensitivity. GH treatment does not alter MGU despite decreased whole body insulin sensitivity. A perturbed cardiac glucose uptake appears to be a feature of TS.
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.|Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Christian
authors: C
authors: Trolle
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.
authors: Britta
authors: B
authors: Hjerrild
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.|University Department of Radiology, Cambridge University Hospitals, Cambridge, UK.
authors: Kristian Havmand
authors: KH
authors: Mortensen
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.
authors: Sine
authors: S
authors: Knorr
authors: Department of Cardiology, Regional Hospital of Viborg, Viborg, Denmark.
authors: Hanne Maare
authors: HM
authors: Søndergaard
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.
authors: Jens Sandahl
authors: JS
authors: Christiansen
authors: Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark.|Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Claus Højbjerg
authors: CH
authors: Gravholt
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D004311:Double-Blind Method; D005260:Female; D019788:Fluorodeoxyglucose F18; D015309:Glucose Clamp Technique; D006321:Heart / Q000000981:diagnostic imaging / Q000187:drug effects*; D019382:Human Growth Hormone / Q000494:pharmacology*; D006801:Humans; D007333:Insulin Resistance; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D055414:Myocardial Perfusion Imaging; D009206:Myocardium / Q000378:metabolism*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014424:Turner Syndrome / Q000000981:diagnostic imaging / Q000378:metabolism*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D019382:Human Growth Hormone