Prevalence and clinical characteristics of metabolic syndrome in Turner syndrome: A single center study in Guangzhou

Objective To investigate the prevalence and clinical characteristics of metabolic syndrome (MetS) in Turner's syndrome (TS),and to analyze the possible early risk factors of MetS in TS girls.Methods The study comprised 47 TS patients confirmed by clinical manifestations and karyotype analysis carried out in First Affiliated Hospital of Sun Yat-sen University during 2010 to 2013.Height,weight,waist circumstance,and resting blood pressure were measured,and plasma fasting glucose,insulin,total cholesterol,high density lipoproteincholesterol (HDL-C),and triglycerides were determined before any treatment.Body mass index (B MI),BMI Z-Score (BMI-SDS),waist-to-height ratio (WHtR),and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.All data were analyzed and described according to the guideline on children and adolescents metabolic syndrome from Chinese Medical Association of pediatrics published in June 2012,38 patients older than or equal to 10 years of age were recruited in group Ⅰ,and 9 patients within 6 to 10 years old formed group Ⅱ.Group Ⅰ was further divided into 5 subgroups based on their metabolic components according to guideline,viz.MetS group,group with 1 variable,group with 2 variables,group with 3 variables,and control group.Statistical analysis was conducted in group Ⅰ,and the metabolic characteristics was described in group Ⅱ.Results Positive correlations existed in total cholesterol,non-HDL-C,and triglycerides with age (r =0.409,P＜0.01 ; r =0.35,P＜0.05 ; r =0.356,P＜0.05) while negative correlation existed in BMI-SDS(r =-0.35,P＜0.05) in all 47 TS patients.In group Ⅰ,the prevalence of MetS,insulin resistance,hypertension,low HDL-C or high non-HDL-C,hypertriglyceridemia,hyperglycemia,hyperinsulinism,diabetes,and central obesity was 13.15％,10.53％,28.9％,26.32％,23.68％,15.79％,5.26％,2.63％,and 18.42％ respectively.TS patients of MetS group had wasit circumference [(73.90±0.93vs60.75±1.44)cm,P＜0.0167],WHtR (0.54 ± 0.01 vs0.45±0.01,P＜0.0167),BMI [(21.50 ± 0.78 vs 16.89 ± 0.61) kg/m2,P＜0.016 7],BMI-SDS (1.08 ± 0.39 vs-0.76 ± 0.29,P＜0.016 7),triglycerides [1.65 (0.61-2.69) vs 0.75 (0.30-1.20) mmol/L,P＜0.016 7].WHtR (0.47 ± 0.01 vs 0.45 ± 0.01,P＜0.016 7) in the group with 1 variable was significantly higher than those in the control,while HDL-C was lower [1.19(0.75-1.63) vs 1.51 (1.21-1.81),P＜0.016 7].No significant difference was found in total cholesterol,blood pressure,non-HDL-C,and insulin or HOMA-IR among other groups.4 patients in group Ⅱ exhibited 1 cardiovascular risk component,3 with hypertension and 1 with lipid metabolic disorders.1 patient exhibited 2 cardiovascular risk components with central obesity and hypertension.Conclusion TS patients are prone to MetS,which may occur at early stage of the development of TS.Hypertension and dyslipidemia occur most frequently and may be related to congenital disorders of TS.The insulin resistance related to delayed β-cell response and glucose intolerance is possibly one of the early pathophysiological changes which cause the metabolic disorders in TS patients.Central obesity forms the early stage of the development of MetS.Anthropometric assessing like WHtR might predict the presence of early metabolic disorders much better than WC,wasit circumference,BMI,or BMI-SDS. Key words: Metabolic syndrome;  Insulin resistance;  Obesity ;  Turner's syndrome