Bone mineral density and insulin resistance in patients with turner's syndrome

ABSTRACT

The aim of this work was to study bone mineral density [BMD], gonadotropins and insulin resistance in girls with Turner's syndrome and its correlation with some growth parameters. This work comprise 14 patients with Tumers syndrome [mean age +/- SD 11.93 +/- 3.79years] and 14 healthy age matched Egyptian females as a control group. Thorough anthropometric measurements were done for patients and controls and are expressed as standard deviation score utilizing Egyptian growth table for height and international tables for ideal weight for height. Lumber2-lumber4 [L2. L4], BMD was done using dual energy X-ray absorptiometery [DEXA] [using lunar DPXIQ, USA], in Patients and controls and compared to 352 healthy age and sex matched Egyptian controls. Morning blood sample after over night fast was used for estimation of FSH, LH, insulin [Elisa] and blood glucose. Insulin resistance index [IRl] and relative insulin resistance [RIR] were calculated from fasting blood glucose and fasting insulin. The results shows significant decrease in height with significant increase in weight%to ideal weight for height in turner patients compared to controls with significant higher FSH, LH and increased lRl, RIR while BMD of L2-L4 showed significant osteopenia. Correlation studies shows significant positive correlation between height SD score and L2-L4 BMD and significant negative correlation between it and wt%to ideal weight for height and measures of insulin resistance, FSH awl LH demonstrated negative correlation with L2-L4 BMD and height SD score. Insulin resistance indices demonstrated a positive correlation with wt%to ideal weight for height and negative correlation with BMD. Turner's syndrome is associated with significant short stature, and overweight with significant osteopenia and insulin resistance. Height SD score is positively correlated with BMD and negatively correlated with wt% to ideal wt for height, FSH, LH, IRl and RIR. FSH and LH showed significant negative correlation with BMD