ESPE Abstracts

Background and Objectives: In the patients with Turner syndrome (TS), the risk of hypertension is higher in childhood and adulthood. The aim of the study was to retrospectively analyze 24-hour ambulatory blood pressure monitoring (ABPM) in children and adolescents with TS and its related factors.

Materials and Methods: A retrospective study was conducted involving TS patients admitted to our pediatric endocrine specialist clinics, the First Affiliated Hospital, Sun Yat-sen University, between January 2012 and December 2018. All patients completed anthropometric measurement, 24-hour ABPM, testing of cholesterol (CHOL), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), blood urea nitrogen (BUN), creatinine (Cr), fasting glucose, fasting insulin, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and progesterone (P), testosterone (T), 8 am cortisol, echocardiography and abdominal ultrasound.

Results: A total of 27 patients with TS were identified，ranging in age from 7 to 23 years old (13.41±4.88), and 9 patients with ambulatory hypertension were detected by 24-hour ABPM. Among these 9 patients, 1 patient had elevated mean daytime blood pressure (BP), 4 patients had elevated mean nighttime BP, and 4 patients had elevated mean daytime and nighttime BP. The circadian rhythm with dipper BP pattern accounted for 33.3%, non-dippers BP pattern accounted for 66.7% of which 4 patients were reverse-dippers. Twenty-one patients had a decrease more than 10% of pulse rate at night. Among 27 TS patients, 2 patients had heart disease (7.4%) and 3 patients had horseshoe kidney (11.1%). The mean diastolic blood pressure (DBP) of TS patients was negatively correlated with HDL-c (P< 0.05). No correlation was found between mean systolic blood pressure (SBP) or DBP and E2 and T (P > 0.05). The decrease rate of SBP at nighttime in TS patients was negatively correlated with FSH, LH, PRL and T (all P< 0.05). The decrease rate of DBP at nighttime was negatively correlated with FSH and LH (all P<0.05). FSH, LH and PRL of the non-dippers BP group were higher than those of the dippers BP group (all P<0.05).

Conclusion: In this study, the detection rate of ambulatory hypertension in TS patients was relatively high, among which non-dippers BP pattern accounted for the majority. Low HDL-c level might be one of the causes of hypertension in Turner syndrome. Sex hormone levels in TS patients might further affect BP, leading to the occurrence of hypertension.