Ambulatory Blood Pressure and Subclinical Cardiovascular Disease in Children With Turner Syndrome

• DOI: 10.1007/s00246-013-0740-2
• Publication Date: 2013-06-22T08:57:20Z
• Authors: Nesibe Akyürek; Mehmet Emre Atabek; Beray Selver Ekli...; Hayrullah Alp
• Keywords: Adolescent; Turkey; Turner Syndrome; Blood Pressure Monitoring, Ambulatory; Prognosis; Carotid Intima-Media Thickness; 3. Good health; 03 medical and health sciences; Carotid Arteries; Early Diagnosis; Vascular Stiffness; 0302 clinical medicine; Cardiovascular Diseases; Research Design; Asymptomatic Diseases; Humans; Female; Preventive Medicine; Insulin Resistance; Child

Patients with Turner syndrome (TS) have an increased risk of cardiovascular morbidity. 29 TS and 25 healthy control subjects (CS) were included in the study. We investigated body mass index, waist circumference, fasting glucose and insulin, homeostatic model assessment (HOMA) index, serum lipids, oral glucose tolerance test, 24-h ambulatory blood pressure (BP) monitoring, and carotid intima-media thickness (CIMT) and compared them with CS. 28 % (N = 7) of TS had insulin resistance (IR), and 36 % (N = 9) had IGT. Mean systolic BP and diastolic BP (DBP) dip were 7.24 ± 3.97 % and 11.84 ± 6.2 %, respectively. CIMT was greater in TS than in CS (p = 0.00). CIMT was correlated positively with fasting insulin, HOMA index, and insulin-sensitivity check index (r = 0.563, p = 0.015; r = 0.603, p = 0.008; and r = 0.623, p = 0.006, respectively) and negatively with fasting glucose-to-insulin ratio and DBP dipping (r = -0.534, p = 0.022; r = -0.534, p = 0.00, respectively) in the two groups combined. These results provide additional evidence for the presence of subclinical cardiovascular disease and its relation to hypertension in TS. They also indicate a significant relation between DBP dipping and increased arterial stiffness. It is also important to note that our findings show significant relationships between insulin sensitivity and cardiovascular changes and underline the importance of insulin resistance for predicting cardiovascular disease.