ESPE Abstracts

Aim: To evaluate the metabolic status in children with Turner syndrome (TS) depending on the Tanner stage (Pre-puberty and puberty).

Methods: The total studied group consisted of 85 children with TS from 8 to 17 years, who were regularly followed-up in the University hospital (Minsk) and age matched 72 healthy controls. TS was diagnosed in patients with characteristic phenotypic signs according to the results of karyotyping at the age of 8.2±5.16 years. 41 patients were in pre-puberty (mean age 11.86 (9.21;13.25) years vs 8.97(7.86;9.54) years in pre-puberty control group, P=0.001). 44 girls had II-V stage of sexual development according to Tanner (mean age 15.63 (14.37;17.03) years). Spontaneous puberty was observed in 13 girls. 31 patients underwent puberty initiation. Body composition using dual-energy X-ray absorptiometry, body mass index (BMI), serum concentrations of insulin, glucose, lipids were measured in all groups of patients.

Results: 68.2% of TS girls had normal body weight, 25.9% were overweight, 5.9% had obesity. Significantly higher values of BMI (20.52 (18.34;23.22) kg/m2 vs 18.35 (16.30;20.59) kg/m2, P<0.0001), SDS BMI (0.42 (-0.25;1.31) vs -0.19(-0.73;0.54), P<0.0001), higher percentage of total fat mass (36,2 (28,6; 42,3) kg vs 29,15 (25,63; 37,10) kg, P=0.002) and android region fat mass (36.9 (26.75;44.50) kg vs 30.30 (23.90;38.43) kg, P=0.005) insulin (9.35 (6.77;13.30) µIU/ml vs 6.95 (3.84;10.62) µIU/ml, P=0.011), HOMA-IR (1.99 (1.38;2.90) vs 1.48 (0.82;2.62), P=0.039) and triglycerides (0.86 (0.66;1.06) mmol/l vs 0.69 (0.54;0.90) mmol/l, P=0.007) were revealed in patients with TS compared with the control. There were no significant differences in the SDS BMI (P=0.993), percentage of total fat mass (P=0.285) and android region fat mass (P=0.113) in children with TS in pre-pubertal and pubertal groups. A direct correlation of BMI (ρ=0.435; P=0.003), percentage of total fat mass (ρ=0.346; P=0.022), percentage of fat mass of android region (ρ=0.426; P=0.004) with age was found in pre-pubertal girls with TS. This relationship was not revealed among patients in TS puberty subgroup and in the control subgroups.

Conclusions: Overweight and obesity were detected in 31.76% of girls with TS. Significant increase in the SDS BMI, percentage of total android region fat mass, insulin, HOMA-IR and triglycerides levels in TS patients compared to the control group are predictors of metabolic disorders. Relationship between BMI values, percentage of total android region fat mass with age in the pre-pubertal TS patients may indicate excessive accumulation of fat mass in conditions of estrogen deficiency.