Endocrine Abstracts (2009) 23 OC1.1

Cholesterol and apolipoprotein levels in a cohort of girls with Turner syndrome, and the effect of GH therapy

Chris Gardner, Anne Garden, Mohammed Didi, Paul Newland, Indi Banerjee & Jo Blair


Alder Hey Children’s NHS Foundation Trust, Liverpool, UK.


Introduction: Ischaemic heart disease occurs seven times more frequently in women with Turner syndrome (TS) than the normal population. Adult TS subjects have raised serum cholesterol (Ch). In our service we measure Ch, apolipoprotein A1 (APA) and B (APB) annually in TS patients aged >5 years as APB:APA in childhood is a strong predictor of cardiovascular risk in adult life. Little is known about lipid profiles or the effects of GH or oestrogen (E2) in childhood TS.

Methods: Retrospective study of serum Ch, APA, APB and APB:APA collected at annual review.

Objectives: 1) To describe serum Ch, APA and APB SDS in childhood; 2) to examine associations with GH and E2 treatment.

Results: Of 68 results from 34 subjects age (mean±1S.D.) 13.3±3.87 years at sampling were analysed. Serum Ch SDS was significantly higher in subjects aged >12 years than younger subjects (1.39±0.63 vs 0.35±1.16, P=0.02), persisting after correction for body mass index. There was no significant difference in APA, APB or APB:APA SDS. In regression analysis (GH versus no GH), GH was associated with an increase in APA SDS (0.04±0.90 vs −0.85±0.69 R2=0.159, P=0.03) and reduction in APB:APA SDS (0.13±0.71 vs 1.12±1.82 R2=0.178, P=0.016) but not Ch or APB SDS (Ch 0.86±1.46 vs 0.85±1.39 R2=0.07, P=0.34, APB 0.17±0.86 vs 0.32±1.1 R2=0.055, P=0.475) when controlling for age, BMI SDS and treatment with E2. In subgroup analysis, the association of GH with APA and APB:APA remained significant. E2 treatment was not associated with significant changes in lipid profiles.

Conclusion: The increase in serum Ch in adult TS subjects appears to have its origin in childhood. Treatment with GH is associated with a more favourable APB:APA and may have a role in improving cardiovascular risk in these subjects.

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