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      Favorable Impact of Growth Hormone Treatment on Cholesterol Levels in Turner Syndrome

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          Abstract

          Background: Patients with Turner syndrome (TS) are prone to having metabolic abnormalities, such as obesity, dyslipidemia, hypertension, hyperinsulinemia and type 2 diabetes mellitus, resulting in increased risks of developing atherosclerotic diseases. Objective: To determine the effect of growth hormone (GH) therapy on serum cholesterol levels in prepubertal girls with TS enrolled in the Turner syndrome Research Collaboration (TRC) in Japan. Patients and methods: Eighty-one girls with TS were enrolled in the TRC, and their total cholesterol (TC) levels before GH therapy were compared with reported levels of healthy school-aged Japanese girls. TC levels after 1, 2 and 3 yr of GH treatment were available for 28 of the 81 patients with TS. GH was administered by daily subcutaneous injections, 6 or 7 times/wk, with a weekly dose of 0.35 mg/kg body weight. Results: Baseline TC levels revealed an age-related increase in TS that was in contrast to healthy girls showing unchanged levels. During GH therapy, TC decreased significantly after 1 yr of GH treatment and remained low thereafter. Conclusions: Girls with untreated TS showed an age-related increase in TC that was a striking contrast to healthy girls, who showed unchanged levels. GH therapy in girls with TS brought about a favorable change in TC that indicates the beneficial impact of GH on atherogenic risk.

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          Most cited references15

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          Recommendations for the diagnosis and management of Turner syndrome.

          Comprehensive recommendations on the diagnosis of Turner syndrome (TS) and the care of affected individuals were published in 1994. In the light of recent advances in diagnosis and treatment of TS, an international multidisciplinary workshop was convened in March 2000, in Naples, Italy, in conjunction with the Fifth International Symposium on Turner Syndrome to update these recommendations. The present paper details the outcome from this workshop. The genetics and diagnosis of the syndrome are described, and practical treatment guidelines are presented.
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            Turner's syndrome.

            P Saenger (1996)
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              Monosomy for the X-chromosome is associated with an atherogenic lipid profile.

              Men typically have a more atherogenic lipid profile than women characterized by higher low-density lipoprotein (LDL) cholesterol and triglyceride levels and reduced lipid particle size, contributing to a greater risk for coronary disease. To determine whether X-chromosomal gene dosage affects lipid metabolism independent of sex steroid effects, we compared lipid profiles in age- and body mass-matched young women with ovarian failure, differing only in X-chromosome dosage. Women with premature ovarian failure associated with monosomy X or Turner syndrome (TS, n = 118) were compared with women with 46,XX premature ovarian failure (n = 51) in an in-patient clinical research center unit at the National Institutes of Health. These women were normally on estrogen replacement treatment but discontinued the estrogen 2 wk before study. Fasting lipid levels and nuclear magnetic resonance lipid particle profiles in the two study groups were the major outcomes. Average age and body mass were similar in the two groups of women, but LDL cholesterol (P = 0.001) and triglyceride levels (P = 0.0005) were higher in the TS group. Also among women with TS, average LDL particle size was reduced (P < 0.0001) and LDL particle concentration increased, with a 2-fold increase in the smallest particle categories (P < 0.0001). Whereas total high-density lipoprotein cholesterol levels were similar, high-density lipoprotein particle size was significantly smaller in women with TS, compared with women with premature ovarian failure (P < 0.0001). Women with 45,X with ovarian failure exhibit a distinctly more atherogenic lipid profile than 46,XX women with ovarian failure, suggesting that the second X-chromosome contributes to a more salutary lipid profile in normal women, independent of sex steroid effects.
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                Author and article information

                Journal
                Clin Pediatr Endocrinol
                Clin Pediatr Endocrinol
                CPE
                Clinical Pediatric Endocrinology
                The Japanese Society for Pediatric Endocrinology
                0918-5739
                1347-7358
                24 March 2012
                April 2012
                : 21
                : 2
                : 29-34
                Affiliations
                [1 ] Department of Pediatrics, Fukuoka Tokushukai Hospital, Fukuoka, Japan
                [2 ] Igarashi Children’s Clinic, Sendai, Japan
                [3 ] Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
                [4 ] Department of Pediatrics, University of Yamanashi, Yamanashi, Japan
                [5 ] Ogawa Clinic Pediatrics and Endocrinology, Nagoya, Japan
                [6 ] J. F. Oberlin University Graduate School of International Studies, Machida, Japan
                [7 ] Department of Pediatrics, Shimane University Faculty of Medicine, Izumo, Japan
                [8 ] Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan
                [9 ] Osaka Kosei Nenkin Hospital, Osaka, Japan
                [10 ] Chibashi Ryoiku Center, Chiba, Japan
                [11 ] Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
                [12 ] Research and Development Division, JCR Pharmaceuticals Co., Ltd. Ashiya, Japan
                [13 ] Department of Pediatrics, Okayama Saiseikai General Hospital, Okayama, Japan
                [14 ] Department of Pediatrics, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan
                [15 ] Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
                [16 ] Department of Pediatrics, Asahikawa Medical College, Asahikawa, Japan
                [17 ] Department of Pediatrics, Osaka City University Hospital, Osaka, Japan
                [18 ] Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
                [19 ] Department of First Specialized Pediatrics, National Center for Child Health and Development, Tokyo, Japan
                [20 ] Department of Pediatric Endocrinology, Osaka City Medical Center, Osaka, Japan
                [21 ] Tanaka Growth Clinic, Tokyo, Japan
                [22 ] The Turner syndrome Research Collaboration (TRC)
                Author notes
                Correspondence: Dr. Hitoshi Kohno, Department of Pediatrics, Fukuoka Tokushukai Hospital, 4-5 Suku-kita, Kasuga, Fukuoka 816-0864, Japan. E-mail: kohno.h@ 123456jcom.home.ne.jp
                Article
                9941
                10.1297/cpe.21.29
                3698903
                23926408
                b03fd817-85a9-4150-9c58-d09aa245a034
                2012©The Japanese Society for Pediatric Endocrinology

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                History
                : 02 November 2011
                : 25 January 2012
                Categories
                Clinical Investigation

                turner syndrome,growth hormone therapy,serum cholesterol

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