Abd-Elmoniem Khaled Z, Bakalov Vladimir K, Matta Jatin R, Muldoon Nancy, Hanover John A, Bondy Carolyn A, Gharib Ahmed M
Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Clin Endocrinol (Oxf). 2014 Sep;81(3):467-70. doi: 10.1111/cen.12481. Epub 2014 Jun 17.
Aortic abnormalities contribute to increased morbidity and mortality of women with Turner syndrome (TS). Impaired aortic stiffness may prove to have clinical prognostic value in TS as is the case in other diseases such as Marfan syndrome, diabetes and hypertension. Additionally, the parental origin of the X chromosome in TS may influence aortic stiffness.
To assess the relation between X chromosome parental origin and aortic stiffness in TS patients.
Twenty-four subjects with TS participated in this cross-sectional study at a tertiary care centre. The parental origin of the X chromosome was determined. Cardiac-gated multidetector computerized tomography (MDCT) was performed and distensibility of the ascending aorta (AA), a measure of aortic stiffness, was calculated.
Fourteen women were Xm (maternal origin) and 10 were Xp (paternal origin) for their inheritance of the single X chromosome. Age, body size, blood pressure and AA areas were similar in the two groups. However, the calculated AA distensibility was significantly lower in the Xm group (2·8 ± 1·1 mm/Hg) than in the Xp group (4·1 ± 1·5 mm/Hg); P < 0·05. Conclusion This study demonstrates that TS subjects that inherit their single X chromosome from their mother (Xm) have a significantly stiffer aorta compared with the TS with a paternally originating X chromosome (Xp), consistent with a potentially greater risk for cardiovascular complications. These findings suggest that parental chromosomal analysis and aortic stiffness measurements would be useful for the risk assessment and clinical management of TS patients.
主动脉异常会导致特纳综合征(TS)女性的发病率和死亡率增加。与马凡综合征、糖尿病和高血压等其他疾病一样,主动脉僵硬度受损在TS中可能具有临床预后价值。此外,TS中X染色体的亲本来源可能会影响主动脉僵硬度。
评估TS患者中X染色体亲本来源与主动脉僵硬度之间的关系。
24名TS患者在一家三级医疗中心参与了这项横断面研究。确定了X染色体的亲本来源。进行了心脏门控多层螺旋计算机断层扫描(MDCT),并计算了升主动脉(AA)的扩张性,这是一种主动脉僵硬度的测量指标。
14名女性的单一X染色体遗传自母亲(Xm),10名遗传自父亲(Xp)。两组的年龄、体型、血压和AA面积相似。然而,Xm组计算出的AA扩张性(2.8±1.1mm/Hg)显著低于Xp组(4.1±1.5mm/Hg);P<0.05。结论:本研究表明,与遗传自父亲的X染色体(Xp)的TS患者相比,遗传自母亲(Xm)的单一X染色体的TS患者的主动脉僵硬度明显更高,这与心血管并发症的潜在风险更大一致。这些发现表明,亲本染色体分析和主动脉僵硬度测量对于TS患者的风险评估和临床管理将是有用的。