The abnormalities of carbohydrate metabolism in Turner syndrome: analysis of risk factors associated with impaired glucose tolerance

Choi, In Kyoung; Kim, Duk Hee; Kim, Ho-Seong

doi:10.1007/s00431-005-1643-x

Cited by 12 publications

(9 citation statements)

References 36 publications

(29 reference statements)

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“…Lastly, although euglycemic-hyperinsulinemic clamp and the intravenous glucose tolerance test with minimal modeling techniques are more accurate than OGTT, this latter is much more physiological than the intravenous tests, mainly because glucose sensors disseminated by the gastrointestinal tract take part in insulin secretion (34). In addition, studies have shown that OGTT is superior to other tests for the diagnosis of early abnormalities of glucose metabolism in these patients (4,11,13). In summary, a broad variety of correlation coefficients between methods based on fasting data of glucose and insulin vs. methods of OGTT-derived values was found in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Euglycemic-hyperinsulinemic clamp technique (12) is well documented as the gold standard for assessment of IR, but it is too laborious, time-consuming, expensive, and technically complicated. The OGTT has been reported to be superior to other tests (hemoglobin A 1c levels, fasting or postprandial blood glucose concentrations) to detect early abnormalities of glucose metabolism in these patients (4,13). Therefore, in this study, the objectives were to assess insulin sensitivity and pancreatic β-cell function in an adult population of Ecuadorian individuals with TS.…”

Section: Introductionmentioning

confidence: 99%

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Insulin Sensitivity and Pancreatic β-Cell Function in Ecuadorian Women With Turner Syndrome

et al. 2020

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Objective: To assess insulin sensitivity and pancreatic β-cell function in an adult population of Ecuadorian individuals with Turner syndrome (TS). Design and Methods: This was a cross-sectional correlational study conducted in TS subjects (>20 years old; n = 38). A standard 2-h oral glucose tolerance test was performed in both women with TS and the reference group. Glucose, lipids, insulin, and C-peptide concentrations were measured. Homeostasis Model Assessment (HOMA) of Insulin Resistance, Quantitative Insulin Sensitivity Check Index, McAuley, Matsuda, and Belfiore indices were calculated to evaluate the degree of insulin resistance (IR). The pancreatic β-cell function was assessed using HOMA-β, basal C-Peptide Index (CPI), and CPII at 120 ′. Results: A higher prevalence of impaired glucose tolerance was found in TS subjects compared with the reference group. Although significant differences were found for glucose concentrations at 60 ′ and 120 ′ (but not at 0 ′), only the baseline insulin concentrations differed significantly between the two groups. The values of the IR indices were statistically different between study and reference groups. A significant number of TS subjects diagnosed with IR were differently classified according to the index applied. The concentrations of C-peptide at 0 ′ and 120 ′ of TS subjects were similar to those of the control group. In contrast, the CPI and CPII values in the study group were significantly lower than those in the control group. Conclusion: It is impossible to select the best surrogate method for the assessment of IR in women with TS. The CPI and CPII values could be preferable to other indices to assess the pancreatic β-cell function in TS subjects. Our findings suggest that IR and pancreatic β-cell dysfunction could be independent events in women with TS, and both conditions seem to be caused by the disease per se. Our results imply that early screening and intervention for TS would be therapeutic for TS women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Insulin Sensitivity and Pancreatic β-Cell Function in Ecuadorian Women With Turner Syndrome

et al. 2020

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“…Both cross-sectional ( 32 ) and prospective, longitudinal studies ( 3 , 33 ) show that, not surprisingly, the risk of hyperglycemia also increases with age in TS. This phenomenon persists independent of current or prior recombinant GH use ( 33 ), and current ( 33 , 34 ) or prior ( 34 ) estrogen-replacement therapy. Age-related risk of hyperglycemia was also noted in a study of children and adolescents who had never received hormone replacement of any kind ( 16 ).…”

Section: Clinical and Genetic Factors Involved In Hyperglycemia In Tsmentioning

confidence: 99%

Hyperglycemia in Turner syndrome: Impact, mechanisms, and areas for future research

Mitsch

Alexandrou²,

Norris³

et al. 2023

Front. Endocrinol.

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Turner syndrome (TS) is a common chromosomal disorder resulting from complete or partial absence of the second sex chromosome. Hyperglycemia, ranging from impaired glucose tolerance (IGT) to diabetes mellitus (DM), is common in TS. DM in individuals with TS is associated with an 11-fold excess in mortality. The reasons for the high prevalence of hyperglycemia in TS are not well understood even though this aspect of TS was initially reported almost 60 years ago. Karyotype, as a proxy for X chromosome (Xchr) gene dosage, has been associated with DM risk in TS – however, no specific Xchr genes or loci have been implicated in the TS hyperglycemia phenotype. The molecular genetic study of TS-related phenotypes is hampered by inability to design analyses based on familial segregation, as TS is a non-heritable genetic disorder. Mechanistic studies are confounded by a lack of adequate TS animal models, small and heterogenous study populations, and the use of medications that alter carbohydrate metabolism in the management of TS. This review summarizes and assesses existing data related to the physiological and genetic mechanisms hypothesized to underlie hyperglycemia in TS, concluding that insulin deficiency is an early defect intrinsic to TS that results in hyperglycemia. Diagnostic criteria and therapeutic options for treatment of hyperglycemia in TS are presented, while emphasizing the pitfalls and complexities of studying glucose metabolism and diagnosing hyperglycemia in the TS population.

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“…Currently, most researchers tend to use oral glucose tolerance test (OGTT) to study glucose metabolism in TS patients. Studies have shown that OGTT is superior to other tests (fasting blood glucose, postprandial blood glucose, or glycosylated glycoprotein levels) for diagnosis of early abnormalities of glucose metabolism in these patients (18).…”

Section: Overview Of Glucose Metabolism In Ts Patientsmentioning

confidence: 99%

Glucose Metabolism in Turner Syndrome

et al. 2019

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Turner syndrome (TS) is one of the most common female chromosomal disorders. The condition is caused by complete or partial loss of a single X chromosome. Adult patients with TS have a high prevalence of diabetes mellitus (DM). Deranged glucose metabolism in this population seems to be genetically triggered. The traditional risk factors for DM in the general population may not play a major role in the pathogenesis of DM in patients with TS. This review focuses on the latest research studies pertaining to abnormalities of glucose metabolism in TS. We extensively review the available evidence pertaining to the influence of insulin secretion and sensitivity, obesity, autoimmunity, lifestyle, growth hormone, and sex hormone replacement therapy on the occurrence of DM in these patients.

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The abnormalities of carbohydrate metabolism in Turner syndrome: analysis of risk factors associated with impaired glucose tolerance

Abstract: The oral glucose tolerance test is superior to the fasting and postprandial plasma glucose test for the early detection of abnormalities of carbohydrate metabolism in patients with Turner syndrome.

Cited by 12 publications

References 36 publications

Insulin Sensitivity and Pancreatic β-Cell Function in Ecuadorian Women With Turner Syndrome

Insulin Sensitivity and Pancreatic β-Cell Function in Ecuadorian Women With Turner Syndrome

Hyperglycemia in Turner syndrome: Impact, mechanisms, and areas for future research

Glucose Metabolism in Turner Syndrome

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