ESPE Abstracts

Background: Turner syndrome (TS) predisposes to obesity and related metabolic disorders and presents a high risk of congenital heart defects. Growth hormone (GH) treatment used in TS girls also affects the parameters of carbohydrate-lipid metabolism. Thus, the search for new markers that could be early predictors of metabolic disorders seems to be justified.

Objective and Method: The assessment and comparison of MMP-1, MMP-2, MMP-9 (matrix metalloproteinase-1, -2, -9), BDNF (brain-derived neurotrophic factor), GDNF (glial cell line derived neurotrophic factor) and VEGF (vascular endothelial growth factor) and basic clinical makers (total cholesterol, HDL cholesterol, triglycerides, glucose, aminotransferases-ALT, IGF1, TSH and fT4) in 12 untreated (before GH therapy) TS girls vs. 17 healthy short stature girls (control group). Consecutively evaluation of shifts in markers concentrations in 9 TS girls after at least 3-month GH treatment period.

Results: We found no differences in mean age, weight, BMI Z-Score and hSDS between study and control group. Groups differed in mean baseline values of ALT (18.2 ± 4.2 vs. 14.2 ± 4.1, P = 0.02), as well as BDNF [29951.5 (26176.9 – 41271.9) vs. 23131.7 (18392.4 – 28313.3), P = 0.01] and MMP-2 [91.8 (71.7 – 111.0) vs. 143.6 (123.7 - 244.5), P < 0.001]. The regression analysis in all subjects revealed a positive correlation between MMP-2 and HDL concentration (β = 0.502, t(17) = 2.393, P = 0.029), while BDNF significantly predicted BMI Z-score (β = 0.582, t(17) = 2.948, P = 0.009). A significantly higher concentration of MMP-2 was found in patients undergoing GH treatment than before the onset of therapy (132.1 ±42.3 vs. 105.0±45.5, P = 0.045). There were no statistically significant differences between the untreated vs.GH- treated groups in the concentrations of remaining markers.

Conclusion: The higher concentrations of BDNF and lower of MMP-2 in TS girls without metabolic syndrome may reflect the formation of metabolic status. Shifts in MMP-2 concentration during GH therapy may be considered as connected with metabolic alterations.