VANCOUVER -- Researchers here aid that girls diagnosed with Turner Syndrome not only have growth deficiency, but also are prone to obesity, diabetes and other cardiovascular risk factors.
"Often doctors will see a patient with Turner Syndrome and prescribe human growth hormone treatment and may consider that is all that is needed for these children," said Zeina M. Nabhan, MD, of the James Whitcomb Riley Hospital for Children at the Indiana University School of Medicine in Indianapolis.
However, children with Turner Syndrome have a number of other potential health risks, including the tendency toward weight gain and obesity, Nabhan said during a poster presentation on TS treatment at a session of the Lawson Wilkins Pediatric Endocrine Society, included in the Pediatric Academic Societies annual meeting.
"While changes in medical practice have occurred since establishment of the international Turner syndrome guidelines," she wrote in her abstract, "screening for associated comorbidities was deficient in > 50% of our patients with TS."
Nabhan explained that Turner Syndrome is caused by the complete or partial absence of an X chromosome in girls.
"Although short stature is the most prominent characteristic of this disorder, affected girls have a wide range of medical problems, including cardiac, renal, ovarian and hearing problems," she said. As a result, she said, Turner Syndrome patients require life-long surveillance.
In reviewing the medical records of 128 girls identified with Turner Syndrome, Nabhan said the average age of diagnosis was about age 4.
About half were diagnosed at birth because of dysmorphic features, while 48% were identified at about age 9 due to short stature.
At diagnosis, 37% of the girls had cardiac abnormalities, detected either through echocardiography or magnetic resonance imaging, while 32.4% exhibited renal abnormalities and 38% had hyperlipidemia, Nabhan reported.
The girls were initiated on human growth hormone at an average age of 7.3 years and they achieved their final adult height after about 5.7 years of therapy.
In the study, she noted that at the patients' last visit, 48.7% of the girl had body mass index levels in the overweight range and of those girls, 57.3% had a body mass index in the obese range.
Nabhan said the prevalence of co-morbidities in her study was similar to that reported elsewhere.
"Our findings emphasize the need for continual education for all physicians involved in the care of girls with Turner Syndrome. Special emphasis should be placed on routine screening for hyperlipidemia, liver disease and cardiac health, particularly in older girls," she said.
"Prospective studies, aimed not only on detection, but also at prevention of co-morbidities associated with Turner syndrome, are needed."
Nabhan had no relevant disclosures.


Primary source: Pediatric Academic Societies
Source reference:
Nabhan Z, et al, "Medical care of girls with Turner Syndrome; Where are we lacking?" PAS 2010; Abstract 1455.47.