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Cited by 204Genetic and Clinical Aspects of Sex Determination and Chromosomal AbnormalitiesDiabetes, Cardiovascular Risks, and LipoproteinsSexual Differentiation and Disorders

Glucose metabolism, lipid metabolism, and cardiovascular risk factors in adult Turner's syndrome. The impact of sex hormone replacement

Gravholt, Claus Højbjerg, Naeraa, Rune Weis, Nyholm, Birgit, Gerdes, Lars Ulrik, Christiansen, Erik, Schmitz, Ole, Christiansen, Jens Sandahl·1998·Diabetes Care
DOI 10.2337/diacare.21.7.1062
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Abstract

OBJECTIVE: To examine glucose metabolism, blood pressure, physical fitness, and lipid metabolism in adult untreated women with Turner's syndrome compared with a group of normal women and to examine the effects of female sex hormone substitution on these factors. RESEARCH DESIGN AND METHODS: A total of 26 patients with Turner's syndrome were examined before and during sex hormone replacement with 17 beta-estradiol and norethisterone, and an age-matched control group (n = 24) was examined once. A frequently sampled intravenous glucose tolerance test was applied with minimal model assessment. We also performed an oral glucose tolerance test, measurement of 24-h ambulatory blood pressure, and assessment of physical fitness and lipid metabolism. RESULTS: Insulin sensitivity (SI) and glucose effectiveness (SG) were similar in Turner's syndrome patients and control subjects, whereas the acute insulin response (P = 0.03) was lower in Turner's syndrome patients, and no change was seen during sex hormone treatment. Abnormal glucose tolerance was found in 50% of Turner's syndrome patients before and 78% during treatment with sex hormones. Fat-free mass (FFM; P = 0.0005) and physical fitness (P = 0.002) were lower in Turner's syndrome subjects compared with control subjects. During treatment, an increase in FFM (P = 0.001) and physical fitness (P = 0.02) was seen in Turner's syndrome patients. Blood pressure was increased in Turner's syndrome, and a decrease was seen in diastolic blood pressure during treatment with sex hormones. CONCLUSIONS: Turner's syndrome is associated with glucose intolerance, diminished first-phase insulin response, elevated blood pressure, reduced FFM, and physical fitness. Sex hormone administration causes a deterioration in glucose tolerance, increases FFM and physical fitness, and has beneficial effects on blood pressure. The deleterious effect on glucose tolerance may be mediated by norethisterone, a gestagen known to have androgenic effects.

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Crossref · 10.2337/diacare.21.7.1062

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  • Another study showed that blood pressure decreased during treatment with E2 (either oral or TD) for 6 months compared with no treatment for 4 months.

    “Another study showed that blood pressure decreased during treatment with E2 (either oral or TD) for 6 months compared with no treatment for 4 months.357”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [357]

  • The prevalence of hypertension is as high as 20%-40% in children and up to 60% in adults with TS.

    “The prevalence of hypertension is as high as 20%-40% in children441,453 and up to 60% in adults with TS.357,452,454-456”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [357]

  • Individuals with TS are at an increased risk for both type 1 and type 2 diabetes.

    “Individuals with TS are at an increased risk for both type 1 and type 2 diabetes.29,222,227,357,384,706”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [357]

  • The available literature shows that girls and women with TS do not meet current general recommendations for physical activity, which is concerning because less physical activity has been associated with excess weight gain and hypertension in adults with TS.

    “The available literature shows that girls and women with TS do not meet current general recommendations for physical activity,357,455,496-498 which is concerning because less physical activity has been associated with excess weight gain and hypertension in adults with TS.”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [357]

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Authors
Gravholt, C. H., Naeraa, R. W., Nyholm, B., Gerdes, L. U., Christiansen, E., Schmitz, O., & Christiansen, J. S.
Affiliations
  • Aarhus University Hospital (DK)
  • Paediatric Department A, University Hospital of Aarhus Aarhus, Denmark
  • Steno Diabetes Center Gentofte, Denmark
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
1998-07-01
Volume
21
Issue
7
Pages
1062-1070
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.21.7.1062
OpenAlex
W2016362474
Cited by
204
References
0
Citations by year
2026: 3 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 11 · 2018: 12 · 2017: 7 · 2016: 2 · 2015: 7 · 2014: 5 · 2013: 9 · 2012: 5
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Aarhus Universitet
  • Novo Nordisk
  • Diabetesforeningen
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
Turner syndrome, sex hormone replacement therapy, estradiol, norethisterone, impaired glucose tolerance, insulin sensitivity, insulin resistance, insulin response, blood pressure, physical fitness, fat-free mass, lipid metabolism, cardiovascular risk factors
MeSH terms
Administration, Oral, Adult, Blood Glucose, Body Composition, Cardiovascular Diseases, Estradiol, Female, Glucose, Glucose Tolerance Test, Humans, Injections, Intravenous, Insulin, Insulin Resistance, Lipids, Models, Biological, Oxygen Consumption, Risk Factors, Turner Syndrome, Estrogen Replacement Therapy, Blood Pressure Monitoring, Ambulatory, Area Under Curve, Lipid Metabolism

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