O'Gorman Clodagh S, Syme Catriona, Bradley Tim, Hamilton Jill, Mahmud Farid H
Divisions of Endocrinology, The Hospital for Sick Children Research Institute, University of Toronto, Toronto, Canada.
Int J Pediatr Endocrinol. 2012 Apr 2;2012(1):5. doi: 10.1186/1687-9856-2012-5.
Turner Syndrome women are at high risk of vascular disease and the assessment of early risk factors in Turner Syndrome girls is an emerging focus of research. Our objective was to evaluate endothelial function (EF), a preclinical measure of atherosclerosis, in Turner Syndrome girls compared with controls.
A cross-sectional case-control study of Turner Syndrome girls and healthy controls. Subjects underwent fasting insulin and glucose with calculation of HOMA-IR, fasting lipid profile, anthropometrics, and EF testing using peripheral arterial tonometry (PAT). Subjects, aged 10-18 years, had karyotype-confirmed Turner Syndrome; growth hormone (GH), thyroxine and estrogen use were not exclusion criteria. Controls were age- and BMI-matched healthy girls. Fifteen Turner Syndrome and 15 controls were recruited.
Turner Syndrome girls had lower height, higher HDL and higher waist:height ratio than controls. PAT-hyperemia ratio (RH-PAT) scores were lower in Turner Syndrome (1.64 ± 0.34 vs. 2.08 ± 0.32, p = 0.002) indicating impaired EF. Among Turner Syndrome, RH-PAT did not vary with estrogen therapy or with karyotype 45,XO compared with other karyotypes. However, endothelial function was better in GH-treated compared with GH-untreated Turner Syndrome (1.80 ± 0.36 vs. 1.4 + 0.22, p = 0.02) although there were no differences in HOMA-IR, adiponectin or IGF-1.
Girls with Turner Syndrome exhibit impaired endothelial function compared with controls, which may explain higher risk for vascular disease. GH may protect endothelial function in Turner Syndrome.
特纳综合征女性患血管疾病的风险很高，评估特纳综合征女孩的早期风险因素是一个新兴的研究重点。我们的目的是评估与对照组相比，特纳综合征女孩的内皮功能（EF），这是动脉粥样硬化的一种临床前指标。
对特纳综合征女孩和健康对照进行横断面病例对照研究。受试者接受空腹胰岛素和血糖检测并计算HOMA-IR，进行空腹血脂谱、人体测量学检查，以及使用外周动脉张力测定法（PAT）进行内皮功能检测。年龄在10至18岁的受试者经核型确认患有特纳综合征；生长激素（GH）、甲状腺素和雌激素的使用不是排除标准。对照组为年龄和BMI匹配的健康女孩。招募了15名特纳综合征患者和15名对照。
特纳综合征女孩的身高较低，高密度脂蛋白较高，腰高比高于对照组。特纳综合征患者的PAT充血率（RH-PAT）得分较低（1.64±0.34对2.08±0.32，p = 0.002），表明内皮功能受损。在特纳综合征患者中，与其他核型相比，RH-PAT与雌激素治疗或核型45,XO无关。然而，与未接受GH治疗的特纳综合征患者相比，接受GH治疗的患者内皮功能更好（1.80±0.36对1.4 + 0.22，p = 0.02），尽管HOMA-IR、脂联素或IGF-1没有差异。
与对照组相比，特纳综合征女孩表现出内皮功能受损，这可能解释了其患血管疾病的较高风险。生长激素可能保护特纳综合征患者的内皮功能。
