[Lipoprotein a (Lp(a)) in patients with Turner's syndrome]

Women with Turner syndrome (TS) more frequently develop cardiovascular disease. Abnormal lipid metabolism is a well known risk factor for ischemic heart disease.

was to evaluate serum lipid abnormalities, particularly lipoprotein (a) (Lp(a)) in patients with TS.

The study group consisted of 65 girls with TS without clinical signs of thyroid dysfunction or diabetes mellitus. The mean age was 12.45+/-5,03 (2-21) years. X chromosome monosomy was found in 60%, mosaicism in 30.8%, structural aberration in 9.2% of the patients. Most of them (59.7%) received GH treatment, 17.5 had finished treatment prior to the study, 22.8% did not start it yet. Height SDS, BMI SDS, Lp(a), cholesterol, triglycerides, free thyroxin, TSH, insulin, IGF-I, FSH, estradiol were determined.

Thyroid hormone values were within normal ranges in all the patients. In 30.1% (n=20) of them the diagnosis of Hashimoto disease had been established from 1 to 8 years prior to the trial, levothyroxine was administered and euthyreosis was observed. There were significant correlations between Lp(a) and cholesterol (r = 0.37, p=0.005) and Lp(a) and LDL (r=0.48, p<0.001), but not the age, height SDS, BMI SDS and other parameters. There were no significant differences in Lp(a) levels between the groups of patients with different karyotypes. The highest Lp(a) level was observed in patients before GH treatment, the lowest after finishing the treatment but without a statistical significance. We compared the groups of patients with high Lp(a) level (>35 mg/dl) (n=12) to low Lp(a) level (<5 mg/dl) (n=29), but did not find any difference in age, height, BMI, IGF1, insulin level. Only LDL concentration was significantly higher in the first group (p=0.036).

High Lp(a) concentration observed in 18.5% of patients with TS could lead to atherosclerotic process development. Ultrasound monitoring of arteries is therefore advisable. Lp(a) level does not seem to be influenced by karyotype, the age or auxological parameters. However, the evaluation of the influence of GH therapy requires further investigation.