Insulin resistance in adolescents with Turner syndrome is comparable to obese peers, but the overall metabolic risk is lower due to unknown mechanism

Wójcik, Małgorzata; Januś, Dominika; Zygmunt-Górska, Agata; Starzyk, Jerzy

doi:10.1007/s40618-014-0180-8

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…Patients with ovarian dysgenesis due to TS have an increased risk of metabolic disorders, including insulin resistance and diabetes [42,43]. Elevated cholesterol levels in childhood promote the onset of atherosclerosis in adulthood [44].…”

Section: Discussionmentioning

confidence: 99%

“…The development of insulin resistance is influenced by body weight, body composition and karyotype [47,48]. It has been shown that normal-weight women with TS have a lower metabolic risk, potentially related to Fibroblast Growth Factor 21 (FGF 21) metabolism [42]. FGF21 significantly influences metabolism by enhancing insulin sensitivity, regulating glucose uptake, promoting lipid metabolism, increasing energy expenditure, and inducing the browning of white adipose tissue.…”

Section: Discussionmentioning

confidence: 99%

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The Interplay between Muscular Grip Strength and Bone Mineral Density with Consideration of Metabolic and Endocrine Parameters in Individuals with Turner Syndrome

Krzyścin,

Gruca-Stryjak,

Soszka-Przepiera

et al. 2023

Biomedicines

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Introduction: Patients with Turner syndrome (TS) often face skeletal and muscular challenges, including reduced bone mineral density (BMD) and muscle weakness. This comprehensive study sheds light on the complex interplay between muscle strength, BMD, and metabolic and endocrine parameters in TS and healthy subjects. Methods: A cross-sectional study involving 42 TS patients and 70 healthy women was conducted. All patients had their BMD determined in the L1–L4 lumbar spine section and in the whole skeleton as well as the parameters of body fat mass (BF), and visceral fat mass (VF) were also determined. The maximum gripping force was measured with a hydraulic manual dynamometer. In addition, a number of blood hormonal and metabolic parameters were determined. Results: In the TS group, hand grip strength correlated positively with triglyceride levels but not with BMD. Healthy individuals had a positive link between hand grip strength and BMD, while patients with TS did not show a significant association between the two. A trend suggested that longer recombinant human growth hormone (rhGH) therapy might improve BMD in the L1–L4 region. Multiple linear regression analysis revealed that muscle strength assessment may be a potential exponent of reduced BMD, and also used clinically in young adult women but not in individuals with TS. Conclusions: The relationship between BMD variables and hand grip might differ between the two groups, potentially indicating distinct musculoskeletal characteristics in TS patients. Longer rhGH therapy in TS patients may have a positive effect on BMD in the L1–L4 region. Understanding the intricate relationships between these factors is important for optimizing clinical management strategies and improving the quality of life for TS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Interplay between Muscular Grip Strength and Bone Mineral Density with Consideration of Metabolic and Endocrine Parameters in Individuals with Turner Syndrome

Krzyścin,

Gruca-Stryjak,

Soszka-Przepiera

et al. 2023

Biomedicines

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“…The literature suggests the possible participation of obesity and HRT by analogy to the results of research conducted in various groups of patients (4). As women with TS have short stature and abnormal body proportions, they are more likely to be overweight and obese (4,17,18,19,30). In our present study, no relationship was found between obesity and LFTs.…”

Section: Discussionmentioning

confidence: 99%

Liver Biochemical Abnormalities in Adolescent Patients with Turner Syndrome

Wójcik¹,

Ruszała²,

Januś³

et al. 2019

Jcrpe

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Objective:Elevated liver function tests (LFTs) are common in adult Turner syndrome (TS) patients. Data regarding children and adolescents are lacking. To investigate the prevalence of abnormal LFTs in children and adolescents with TS during several years of observation; to evaluate the potential impact of increased body mass index (BMI) and sex hormone replacement therapy (HRT) on LFTs.Methods:The analysis included 100 girls with TS, aged 4-16 years, all of whom were receiving recombinant human growth hormone therapy. A longitudinal study was conducted which included 81 patients.Results:Mean BMI-standard deviation (SD) score of the subjects was 0.63 (SD: 1.53). Forty-four were being treated with HRT. Elevated LFTs were found in 34% of the patients overall (32% not receiving HRT vs 36% on HRT). The relative risk of increased LFTs was not higher in obese vs normal weight [odds ratio (OR): 0.2; 95% confidence interval (CI): 0.1-0.36, p=0.38 vs OR: 0.16; 95% CI: 0.08-0.3, p=0.1]. HRT did not increase the risk of abnormal LFTs activity (OR: 0.8; 95% CI: 0.5-1.2, p=0.37 vs OR: 0.7; 95% CI: 0.4-1.1, p=0.27). During the follow-up period (mean±SD=4.31±0.82 years), no patient developed overt liver disease. There was no significant increase nor decrease of abnormal LFT frequency in the subsequent years of follow up.Conclusion:Constantly elevated LFTs in TS are common in children and adolescents with TS. However the causes and clinical significance remain unclear. This study suggests that obesity and HRT do not increase the risk of elevated LFTs.

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“…Because of short stature and abnormal body proportions, women with Turner syndrome are more likely to be overweight and obese. However, metabolic disorders such as impaired insulin sensitivity, hypercholesterolemia, and liver steatosis are often diagnosed even in non-obese ones [21, 22]. Some data point that metabolic disturbances may be associated with the origin of the X chromosome monosomy itself.…”

Section: Discussionmentioning

confidence: 99%

“…Also insulin resistance is thought to be connected not only with body weight and composition but also with the karyotype [23]. As it was recently shown in survey, overall metabolic risk in normal-weight women with Turner syndrome is lower than in obese peers and some other mechanisms, e.g., FGF 21 may play an important role in this phenomenon [22]. The influence of growth hormone treatment and estrogen replacement on metabolism of patients with TS is significant.…”

Section: Discussionmentioning

confidence: 99%

Prepubertal ultra-low-dose estrogen therapy is associated with healthier lipid profile than conventional estrogen replacement for pubertal induction in adolescent girls with Turner syndrome: preliminary results

Ruszała

Wójcik

Zygmunt-Górska

et al. 2017

J Endocrinol Invest

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PurposeThe metabolic effects of prepubertal low-dose estrogen replacement (LE) therapy in Turner syndrome (TS) have not been fully investigated to date. The present study aimed to compare glucose and lipids metabolism in adolescents with TS on LE and conventional estrogen replacement (CE).MethodsIn 14 TS (mean age 13.8), LE (17β-estradiol, 62.5 μg daily) was introduced before age 12 (mean age 10.5), and followed by a pubertal induction regimen after age 12, and in 14 CE was started after age 12 (mean 14, SD 1.96). Before, and 3 years after starting 17β-estradiol growth velocity, bone age, BMI, and selected parameters of glucose and lipids metabolism were assessed.ResultsThere were no significant differences between LE and CE in the mean levels of any parameter before introduction of 17β-estradiol [total cholesterol (TC): 4.1 vs 4.3 mmol/L, LDL cholesterol (LDLc): 2.2 vs 2.4 mmol/L, HDL cholesterol (HDLc): 1.6 vs 1.4 mmol/L, triglycerides: 0.9 vs 1.0 mmol/L, fasting glucose: 4.2 vs 4.4 mmol/L, post-load glucose: 4.8 vs 5.5 mmol/L; fasting insulin: 6.8 vs 8.0 post-load insulin: 21.3 vs 67.0 μIU/mL, HOMA-IR 1.3 vs 1.6]. After three years of treatment, TC and LDLc levels were significantly lower in LE group (3.8 vs 4.4 mmol/L, p = 0.004; 1.9 vs 2.4 mmol/L, p = 0.03). The other parameters did not differ significantly. There was no negative impact on growth course and bone age advancement nor on BMI in LE group.ConclusionPrepubertal LE is associated with healthier lipid profile than CE in girls with TS.

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Insulin resistance in adolescents with Turner syndrome is comparable to obese peers, but the overall metabolic risk is lower due to unknown mechanism

Abstract: Insulin resistance in adolescents with TS on growth hormone treatment is comparable to Ob patients, but overall metabolic risk factors seem to be lower.

Cited by 6 publications

References 23 publications

The Interplay between Muscular Grip Strength and Bone Mineral Density with Consideration of Metabolic and Endocrine Parameters in Individuals with Turner Syndrome

The Interplay between Muscular Grip Strength and Bone Mineral Density with Consideration of Metabolic and Endocrine Parameters in Individuals with Turner Syndrome

Liver Biochemical Abnormalities in Adolescent Patients with Turner Syndrome

Prepubertal ultra-low-dose estrogen therapy is associated with healthier lipid profile than conventional estrogen replacement for pubertal induction in adolescent girls with Turner syndrome: preliminary results

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