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Current Pharmaceutical Design


ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Review Article

Cardiovascular Complications in Patients with Turner’s Syndrome

Author(s): Eirini Kostopoulou*, Julia K. Bosdou, Panagiotis Anagnostis, John C. Stevenson and Dimitrios G. Goulis

Volume 26, Issue 43, 2020

Page: [5650 - 5659] Pages: 10

DOI: 10.2174/1381612826666200531152459

Price: $65


Turner’s or Turner syndrome (TS) is the most prevalent chromosomal abnormality in live female births. Patients with TS are predisposed to an increased risk of cardiovascular diseases (CVD), mainly due to the frequently observed congenital structural cardiovascular defects, such as valvular and aortic abnormalities (coarctation, dilatation, and dissection). The increased prevalence of cardiometabolic risk factors, such as arterial hypertension, insulin resistance, diabetes mellitus, dyslipidaemia, central obesity, and increased carotid intima-media thickness, also contribute to increased morbidity and mortality in TS patients. Menopausal hormone therapy (MHT) is the treatment of choice, combined with growth hormone (GH). Although MHT may, in general, ameliorate CVD risk factors, its effect on CVD mortality in TS has not yet been established. The exact effect of GH on these parameters has not been clarified. Specific considerations should be provided in TS cases during pregnancy, due to the higher risk of CVD complications, such as aortic dissection. Optimal cardiovascular monitoring, including physical examination, electrocardiogram, CVD risk factor assessment, and transthoracic echocardiography, is recommended. Moreover, the cardiac magnetic resonance from the age of 12 years is recommended due to the high risk of aortic aneurysm and other anatomical vascular complications.

Keywords: Dyslipidaemia, diabetes mellitus, arterial hypertension, aortic coarctation, aortic dilatation; aortic dissection, turner syndrome.

« Previous
McCarthy K, Bondy CA. Turner syndrome in childhood and adolescence. Expert Rev Endocrinol Metab 2008; 3(6): 771-5.
[] [PMID: 19789718]
Donato B, Ferreira MJ. Cardiovascular risk in Turner syndrome. Rev Port Cardiol 2018; 37(7): 607-21.
[] [PMID: 29866389]
Gravholt CH, Andersen NH, Conway GS, et al. Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting. Eur J Endocrinol 2017; 177(3): G1-G70.
[] [PMID: 28705803]
Gravholt CH. Epidemiological, endocrine and metabolic features in Turner syndrome. Eur J Endocrinol 2004; 151(6): 657-87.
[] [PMID: 15588233]
Cameron-Pimblett A, La Rosa C, King TFJ, Davies MC, Conway GS. The Turner syndrome life course project: Karyotype-phenotype analyses across the lifespan. Clin Endocrinol (Oxf) 2017; 87(5): 532-8.
[] [PMID: 28617979]
Livadas S, Xekouki P, Fouka F, et al. Prevalence of thyroid dysfunction in Turner’s syndrome: a long-term follow-up study and brief literature review. Thyroid 2005; 15(9): 1061-6.
[] [PMID: 16187915]
O’Gorman CS, Syme C, Lang J, Bradley TJ, Wells GD, Hamilton JK. An evaluation of early cardiometabolic risk factors in children and adolescents with Turner syndrome. Clin Endocrinol (Oxf) 2013; 78(6): 907-13.
[] [PMID: 23106295]
Gravholt CH, Landin-Wilhelmsen K, Stochholm K, et al. Clinical and epidemiological description of aortic dissection in Turner’s syndrome. Cardiol Young 2006; 16(5): 430-6.
[] [PMID: 16984695]
Schoemaker MJ, Swerdlow AJ, Higgins CD, Wright AF, Jacobs PA. Mortality in women with turner syndrome in Great Britain: a national cohort study. J Clin Endocrinol Metab 2008; 93(12): 4735-42.
[] [PMID: 18812477]
Lin AE, Silberbach M. Focus on the heart and aorta in Turner syndrome. J Pediatr 2007.150572
Bondy CA. Congenital cardiovascular disease in Turner syndrome. Congenit Heart Dis 2008; 3: 2-15.
Turtle EJ, Sule AA, Bath LE, et al. Assessing and addressing cardiovascular risk in adults with Turner syndrome. Clin Endocrinol (Oxf) 2013; 78(5): 639-45.
[] [PMID: 23173989]
De Groote K, Demulier L, De Backer J, et al. Arterial hypertension in Turner syndrome: a review of the literature and a practical approach for diagnosis and treatment. J Hypertens 2015; 33(7): 1342-51.
[] [PMID: 26039527]
Sachdev V, Matura LA, Sidenko S, et al. Aortic valve disease in Turner syndrome. J Am Coll Cardiol 2008; 51(19): 1904-9.
[] [PMID: 18466808]
Klásková E, Zapletalová J, Kaprálová S, et al. Increased prevalence of bicuspid aortic valve in Turner syndrome links with karyotype: the crucial importance of detailed cardiovascular screening. J Pediatr Endocrinol Metab 2017; 30(3): 319-25.
[] [PMID: 28236629]
Mortensen KH, Andersen NH, Gravholt CH. Cardiovascular phenotype in Turner syndrome-integrating cardiology, genetics, and endocrinology. Endocr Rev 2012; 33(5): 677-714.
[] [PMID: 22707402]
Marin A, Weir-McCall JR, Webb DJ, van Beek EJ, Mirsadraee S. Imaging of cardiovascular risk in patients with Turner’s syndrome. Clin Radiol 2015; 70(8): 803-14.
[] [PMID: 25917542]
Yetman AT, Starr L, Sanmann J, Wilde M, Murray M, Cramer JW. Clinical and echocardiographic prevalence and detection of congenital and acquired cardiac abnormalities in girls and women with the Turner syndrome. Am J Cardiol 2018; 122(2): 327-30.
[] [PMID: 29731120]
Ho VB, Bakalov VK, Cooley M, et al. Major vascular anomalies in Turner syndrome: prevalence and magnetic resonance angiographic features. Circulation 2004; 110(12): 1694-700.
[] [PMID: 15353492]
Wong SC, Cheung M, Zacharin M. Aortic dilatation and dissection in Turner syndrome: what we know, what we are unclear about and what we should do in clinical practice? Int J Adolesc Med Health 2014; 26(4): 469-88.
[] [PMID: 24887949]
Duijnhouwer AL, Bons LR, Timmers HJLM, et al. Aortic dilatation and outcome in women with Turner syndrome. Heart 2019; 105(9): 693-700.
[] [PMID: 30368486]
Mortensen KH, Gopalan D, Nørgaard BL, Andersen NH, Gravholt CH. Multimodality cardiac imaging in Turner syndrome. Cardiol Young 2016; 26(5): 831-41.
[] [PMID: 26843123]
Matura LA, Ho VB, Rosing DR, Bondy CA. Aortic dilatation and dissection in Turner syndrome. Circulation 2007; 116(15): 1663-70.
[] [PMID: 17875973]
Mortensen KH, Erlandsen M, Andersen NH, Gravholt CH. Prediction of aortic dilation in Turner syndrome-the use of serial cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2013; 15: 47.
[] [PMID: 23742092]
Carlson M, Airhart N, Lopez L, Silberbach M. Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in Turner syndrome: report of the international turner syndrome aortic dissection registry. Circulation 2012; 126(18): 2220-6.
[] [PMID: 23032325]
Carlson M, Silberbach M. Dissection of the aorta in Turner syndrome: two cases and review of 85 cases in the literature. J Med Genet 2007; 44(12): 745-9.
[] [PMID: 17873120]
De Groote K, Devos D, Van Herck K, et al. Increased aortic stiffness in prepubertal girls with Turner syndrome. J Cardiol 2017; 69(1): 201-7.
[] [PMID: 27056149]
Pirgon Ö, Atabek ME, Oran B, Güçlü R. Atherogenic lipid profile and systolic blood pressure are associated with carotid artery intima-media thickness in children with Turner syndrome. J Clin Res Pediatr Endocrinol 2008; 1(2): 62-71.
[] [PMID: 21318066]
Kozlowska-Wojciechowska M, Jez W, Zdrojewski T, Chwojnicki K. Are young women with Turner syndrome at greater risk of coronary artery disease? Eur J Cardiovasc Prev Rehabil 2006; 13(3): 467-9.
[] [PMID: 16926680]
Ostberg JE, Donald AE, Halcox JP, Storry C, McCarthy C, Conway GS. Vasculopathy in Turner syndrome: arterial dilatation and intimal thickening without endothelial dysfunction. J Clin Endocrinol Metab 2005; 90(9): 5161-6.
[] [PMID: 15985480]
Trolle C, Hjerrild B, Cleemann L, Mortensen KH, Gravholt CH. Sex hormone replacement in Turner syndrome. Endocrine 2012; 41(2): 200-19.
[] [PMID: 22147393]
Gravholt CH, Naeraa RW, Nyholm B, et al. Glucose metabolism, lipid metabolism, and cardiovascular risk factors in adult Turner’s syndrome. The impact of sex hormone replacement. Diabetes Care 1998; 21(7): 1062-70.
[] [PMID: 9653596]
Giordano R, Forno D, Lanfranco F, Manieri C, Ghizzoni L, Ghigo E. Metabolic and cardiovascular outcomes in a group of adult patients with Turner’s syndrome under hormonal replacement therapy. Eur J Endocrinol 2011; 164(5): 819-26.
[] [PMID: 21378088]
Ross JL, Feuillan P, Long LM, Kowal K, Kushner H, Cutler GB Jr. Lipid abnormalities in Turner syndrome. J Pediatr 1995; 126(2): 242-5.
[] [PMID: 7844670]
Garden AS, Diver MJ, Fraser WD. Undiagnosed morbidity in adult women with Turner’s syndrome. Clin Endocrinol (Oxf) 1996; 45(5): 589-93.
[] [PMID: 8977756]
O’Gorman CS, Syme C, Bradley T, Hamilton J, Mahmud FH. Impaired endothelial function in pediatric patients with turner syndrome and healthy controls: a case-control study. Int J Pediatr Endocrinol 2012; 2012(1): 5.
[] [PMID: 22472028]
Elsheikh M, Dunger DB, Conway GS, Wass JA. Turner’s syndrome in adulthood. Endocr Rev 2002; 23(1): 120-40.
[PMID: 11844747]
Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA 2005; 294(3): 326-33.
[] [PMID: 16030277]
Xydakis AM, Ballantyne CM. Role of non-high-density lipoprotein cholesterol in prevention of cardiovascular disease: updated evidence from clinical trials. Curr Opin Cardiol 2003; 18(6): 503-9.
[] [PMID: 14597892]
National Heart, Lung, and Blood Institute Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128: 213-56.
Kelley JC, Gutmark-Little I, Backeljauw P, Bamba V. Increased non-high-density lipoprotein cholesterol in children and young adults with Turner syndrome is not explained by BMI alone. Horm Res Paediatr 2017; 88(3-4): 208-14.
[] [PMID: 28768282]
Frontini MG, Srinivasan SR, Xu J, Tang R, Bond MG, Berenson GS. Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: the Bogalusa Heart Study. Pediatrics 2008; 121(5): 924-9.
[] [PMID: 18450895]
Wilson DM, Frane JW, Sherman B, Johanson AJ, Hintz RL, Rosenfeld RG. Carbohydrate and lipid metabolism in Turner syndrome: effect of therapy with growth hormone, oxandrolone, and a combination of both. J Pediatr 1988; 112(2): 210-7.
[] [PMID: 3276862]
Ostberg JE, Attar MJ, Mohamed-Ali V, Conway GS. Adipokine dysregulation in turner syndrome: comparison of circulating interleukin-6 and leptin concentrations with measures of adiposity and C-reactive protein. J Clin Endocrinol Metab 2005; 90(5): 2948-53.
[] [PMID: 15728208]
Honigberg MC, Zekavat SM, Aragam K, et al. Association of premature natural and surgical menopause with incident cardiovascular disease. JAMA 2019; 322: 2411-21.
[] [PMID: 31738818]
Freedman DS, Srinivasan SR, Harsha DW, Webber LS, Berenson GS. Relation of body fat patterning to lipid and lipoprotein concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 1989; 50(5): 930-9.
[] [PMID: 2816800]
Caprio S, Boulware S, Diamond M, et al. Insulin resistance: an early metabolic defect of Turner’s syndrome. J Clin Endocrinol Metab 1991; 72(4): 832-6.
[] [PMID: 2005209]
Chait A, Bierman EL, Albers JJ. Low-density lipoprotein receptor activity in cultured human skin fibroblasts. Mechanism of insulin-induced stimulation. J Clin Invest 1979; 64(5): 1309-19.
[] [PMID: 227931]
Stout RW. The effect of insulin and glucose on sterol synthesis in cultured rat arterial smooth muscle cells. Atherosclerosis 1977; 27(3): 271-8.
[] [PMID: 901624]
Los E, Quezada E, Chen Z, Lapidus J, Silberbach M. Pilot study of blood pressure in girls with Turner syndrome: an awareness gap, clinical associations, and new hypotheses. Hypertension 2016; 68(1): 133-6.
[] [PMID: 27217413]
Nathwani NC, Unwin R, Brook CG, Hindmarsh PC. Blood pressure and Turner syndrome. Clin Endocrinol (Oxf) 2000; 52(3): 363-70.
[] [PMID: 10718835]
Donaldson MD, Gault EJ, Tan KW, Dunger DB. Optimising management in Turner syndrome: from infancy to adult transfer. Arch Dis Child 2006; 91(6): 513-20.
[] [PMID: 16714725]
Nathwani NC, Unwin R, Brook CG, Hindmarsh PC. The influence of renal and cardiovascular abnormalities on blood pressure in Turner syndrome. Clin Endocrinol (Oxf) 2000; 52(3): 371-7.
[] [PMID: 10718836]
Akyürek N, Atabek ME, Eklioglu BS, Alp H. Ambulatory blood pressure and subclinical cardiovascular disease in children with turner syndrome. Pediatr Cardiol 2014; 35(1): 57-62.
[] [PMID: 23794013]
Fudge EB, Constantacos C, Fudge JC, Davenport M. Improving detection of hypertension in girls with turner syndrome using ambulatory blood pressure monitoring. Horm Res Paediatr 2014; 81(1): 25-31.
[] [PMID: 24281046]
Marchini A, Häcker B, Marttila T, et al. BNP is a transcriptional target of the short stature homeobox gene SHOX. Hum Mol Genet 2007; 16(24): 3081-7.
[] [PMID: 17881654]
von Kaisenberg CS, Nicolaides KH, Brand-Saberi B. Lymphatic vessel hypoplasia in fetuses with Turner syndrome. Hum Reprod 1999; 14(3): 823-6.
[] [PMID: 10221720]
Kenny D, Polson JW, Martin RP, Paton JF, Wolf AR. Hypertension and coarctation of the aorta: an inevitable consequence of developmental pathophysiology. Hypertens Res 2011; 34(5): 543-7.
[] [PMID: 21412243]
Sharma J, Friedman D, Dave-Sharma S, Harbison M. Aortic distensibility and dilation in Turner’s syndrome. Cardiol Young 2009; 19(6): 568-72.
[] [PMID: 19857368]
Freriks K, Timmermans J, Beerendonk CC, et al. Standardized multidisciplinary evaluation yields significant previously undiagnosed morbidity in adult women with Turner syndrome. J Clin Endocrinol Metab 2011; 96(9): E1517-26.
[] [PMID: 21752892]
Zuckerman-Levin N, Zinder O, Greenberg A, Levin M, Jacob G, Hochberg Z. Physiological and catecholamine response to sympathetic stimulation in turner syndrome. Clin Endocrinol (Oxf) 2006; 64(4): 410-5.
[] [PMID: 16584513]
Lastra G, Syed S, Kurukulasuriya LR, Manrique C, Sowers JR. Type 2 diabetes mellitus and hypertension: an update. Endocrinol Metab Clin North Am 2014; 43(1): 103-22.
[] [PMID: 24582094]
Maric-Bilkan C, Gilbert EL, Ryan MJ. Impact of ovarian function on cardiovascular health in women: focus on hypertension. Int J Womens Health 2014; 6: 131-9.
[] [PMID: 24493934]
Cicognani A, Mazzanti L, Tassinari D, et al. Differences in carbohydrate tolerance in Turner syndrome depending on age and karyotype. Eur J Pediatr 1988; 148(1): 64-8.
[] [PMID: 3058482]
Bakalov VK, Cheng C, Zhou J, Bondy CA. X-chromosome gene dosage and the risk of diabetes in Turner syndrome. J Clin Endocrinol Metab 2009; 94(9): 3289-96.
[] [PMID: 19567529]
Ibarra-Gasparini D, Altieri P, Scarano E, et al. New insights on diabetes in Turner syndrome: results from an observational study in adulthood. Endocrine 2018; 59(3): 651-60.
[] [PMID: 28593616]
Bakalov VK, Cooley MM, Quon MJ, et al. Impaired insulin secretion in the Turner metabolic syndrome. J Clin Endocrinol Metab 2004; 89(7): 3516-20.
[] [PMID: 15240640]
Helena Mangs A, Morris BJ. The human pseudoautosomal region (PAR): origin, function and guture. Curr Genomics 2007; 8(2): 129-36.
[] [PMID: 18660847]
Anagnostis P, Christou K, Artzouchaltzi AM, et al. Early menopause and premature ovarian insufficiency are associated with increased risk of type 2 diabetes: a systematic review and meta-analysis. Eur J Endocrinol 2019; 180(1): 41-50.
[] [PMID: 30400047]
Ari M, Bakalov VK, Hill S, Bondy CA. The effects of growth hormone treatment on bone mineral density and body composition in girls with turner syndrome. J Clin Endocrinol Metab 2006; 91(11): 4302-5.
[] [PMID: 16940444]
Sun L, Wang Y, Zhou T, et al. Glucose Metabolism in Turner Syndrome. Front Endocrinol (Lausanne) 2019; 10: 49.
[] [PMID: 30792694]
Wilkin TJ, Murphy MJ. The gender insulin hypothesis: why girls are born lighter than boys, and the implications for insulin resistance. Int J Obes 2006; 30(7): 1056-61.
[] [PMID: 16801943]
Cannavale G, Francone M, Galea N, et al. Fatty Images of the Heart: Spectrum of Normal and Pathological Findings by Computed Tomography and Cardiac Magnetic Resonance Imaging. BioMed Res Int 2018.20185610347
[] [PMID: 29503824]
Mittal SR. Diagnosis of coronary microvascular dysfunction - Present status. Indian Heart J 2015; 67(6): 552-60.
[] [PMID: 26702685]
Bianchi I, Lleo A, Gershwin ME, Invernizzi P. The X chromosome and immune associated genes. J Autoimmun 2012; 38(2-3): J187-92.
[] [PMID: 22178198]
Bolar K, Hoffman AR, Maneatis T, Lippe B. Long-term safety of recombinant human growth hormone in turner syndrome. J Clin Endocrinol Metab 2008; 93(2): 344-51.
[] [PMID: 18000090]
Holl RW, Kunze D, Etzrodt H, Teller W, Heinze E. Turner syndrome: final height, glucose tolerance, bone density and psychosocial status in 25 adult patients. Eur J Pediatr 1994; 153(1): 11-6.
[] [PMID: 8313917]
Bondy CA. Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab 2007; 92(1): 10-25.
[] [PMID: 17047017]
Calcaterra V, Brambilla P, Maffè GC, et al. Metabolic syndrome in Turner syndrome and relation between body composition and clinical, genetic, and ultrasonographic characteristics. Metab Syndr Relat Disord 2014; 12(3): 159-64.
[] [PMID: 24447068]
Melander A, Olsson J, Lindberg G, et al. 35th Annual Meeting of the European Association for the Study of Diabetes: Brussels, Belgium, 28 September-2 October 1999. Diabetologia 1999; 42(Suppl. 1): A1-A330.
[] [PMID: 27770183]
Gravholt CH, Hjerrild BE, Mosekilde L, et al. Body composition is distinctly altered in Turner syndrome: relations to glucose metabolism, circulating adipokines, and endothelial adhesion molecules. Eur J Endocrinol 2006; 155(4): 583-92.
[] [PMID: 16990658]
Ostberg JE, Thomas EL, Hamilton G, Attar MJ, Bell JD, Conway GS. Excess visceral and hepatic adipose tissue in Turner syndrome determined by magnetic resonance imaging: estrogen deficiency associated with hepatic adipose content. J Clin Endocrinol Metab 2005; 90(5): 2631-5.
[] [PMID: 15713713]
Schoepp M, Hannah-Shmouni F, Matta J, et al. Coronary calcification in adults with Turner syndrome. Genet Med 2018; 20(6): 664-8.
[] [PMID: 29176683]
Fuchs MM, Attenhofer Jost C, Babovic-Vuksanovic D, Connolly HM, Egbe A. Long-term outcomes in patients with Turner syndrome: A 68-year follow-up. J Am Heart Assoc 2019; 8(11)e011501
[] [PMID: 31131660]
Klein KO, Rosenfield RL, Santen RJ, et al. Estrogen replacement in Turner syndrome: Literature review and practical considerations. J Clin Endocrinol Metab 2018; 103(5): 1790-803.
[] [PMID: 29438552]
Massa G, Otten BJ, de Muinck Keizer-Schrama SM, et al. Treatment with two growth hormone regimens in girls with Turner syndrome: final height results. Horm Res 1995; 43(4): 144-6.
[] [PMID: 7750917]
Van den Broeck J, Massa GG, Attanasio A, et al. Final height after long-term growth hormone treatment in Turner syndrome. J Pediatr 1995; 127(5): 729-35.
[] [PMID: 7472824]
Reddy Danda VS, Sreedevi P, Arun G, Rao PS. Growth hormone treatment in Turner’s syndrome: A real world experience. Indian J Endocrinol Metab 2017; 21(3): 378-81.
[] [PMID: 28553590]
Elsheikh M, Bird R, Casadei B, Conway GS, Wass JA. The effect of hormone replacement therapy on cardiovascular hemodynamics in women with Turner’s syndrome. J Clin Endocrinol Metab 2000; 85(2): 614-8.
[PMID: 10690864]
Ostberg JE, Storry C, Donald AE, Attar MJ, Halcox JP, Conway GS. A dose-response study of hormone replacement in young hypogonadal women: effects on intima media thickness and metabolism. Clin Endocrinol (Oxf) 2007; 66(4): 557-64.
[] [PMID: 17371475]
Chan NN, Vallance P, Colhoun HM, MacAllister RJ, Hingorani AD, Conway GS. The effects of hormone replacement therapy on endothelial function in women with Turner’s syndrome. Clin Endocrinol (Oxf) 2002; 56(5): 615-20.
[] [PMID: 12030912]
Colao A. The GH-IGF-I axis and the cardiovascular system: clinical implications. Clin Endocrinol (Oxf) 2008; 69(3): 347-58.
[] [PMID: 18462260]
Thunström S, Krantz E, Thunström E, Hanson C, Bryman I, Landin-Wilhelmsen K. Incidence of aortic dissection in Turner syndrome. A 23-year prospective cohort study. Circulation 2019; 139(24): 2802-4.
[] [PMID: 31180751]
Ostberg JE, Conway GS. Adulthood in women with Turner syndrome. Horm Res 2003; 59(5): 211-21.
[PMID: 12714784]
Irzyniec TJ, Jeż W. The influence of hormonal replacement and growth hormone treatment on the lipids in Turner syndrome. Gynecol Endocrinol 2014; 30(3): 250-3.
[] [PMID: 24400597]
Zaiem F, Alahdab F, Al Nofal A, Murad MH, Javed A. Oral versus transdermal estrogen in Turner syndrome: a systematic review and meta-analysis. Endocr Pract 2017; 23(4): 408-21.
[] [PMID: 28095041]
Qi W, Li S, Shen Q, Guo X, Rong H. Effects of recombinant human growth hormone therapy on carbohydrate, lipid and protein metabolisms of children with Turner syndrome. Pak J Med Sci 2014; 30(4): 731-4.
[] [PMID: 25097506]
Irzyniec TJ, Jez W. A beneficial effect of estradiol on blood pressure, not on glucose and lipids levels in women with Turner syndrome. Gynecol Endocrinol 2014; 30: 250-3.
[] [PMID: 24400597]
Lanes R, Gunczler P, Palacios A, Villaroel O. Serum lipids, lipoprotein lp(a), and plasminogen activator inhibitor-1 in patients with Turner’s syndrome before and during growth hormone and estrogen therapy. Fertil Steril 1997; 68(3): 473-7.
[] [PMID: 9314917]
Koulouri O, Ostberg J, Conway GS. Liver dysfunction in Turner’s syndrome: prevalence, natural history and effect of exogenous oestrogen. Clin Endocrinol (Oxf) 2008; 69(2): 306-10.
[] [PMID: 18248644]
El-Mansoury M, Berntorp K, Bryman I, et al. Elevated liver enzymes in Turner syndrome during a 5-year follow-up study. Clin Endocrinol (Oxf) 2008; 68(3): 485-90.
[] [PMID: 18167134]
Athyros VG, Alexandrides TK, Bilianou H, et al. The use of statins alone, or in combination with pioglitazone and other drugs, for the treatment of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis and related cardiovascular risk. An Expert Panel Statement. Metabolism 2017; 71: 17-32.
[] [PMID: 28521870]
Blethen SL. Complications of growth hormone therapy in children. Curr Opin Pediatr 1995; 7(4): 466-71.
[] [PMID: 7581653]
Radetti G, Crepaz R, Milanesi O, et al. Cardiac performance in Turner’s syndrome patients on growth hormone therapy. Horm Res 2001; 55(5): 240-4.
[PMID: 11740146]
van den Berg J, Bannink EM, Wielopolski PA, et al. Cardiac status after childhood growth hormone treatment of Turner syndrome. J Clin Endocrinol Metab 2008; 93(7): 2553-8.
[] [PMID: 18430775]
Mortensen KH, Hansen KW, Erlandsen M, Christiansen JS, Gravholt CH. Ambulatory arterial stiffness index in Turner syndrome: the impact of sex hormone replacement therapy. Horm Res 2009; 72(3): 184-9.
[] [PMID: 19729951]
Cutfield WS, Wilton P, Bennmarker H, et al. Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment. Lancet 2000; 355(9204): 610-3.
[] [PMID: 10696981]
Radetti G, Pasquino B, Gottardi E, Boscolo Contadin I, Aimaretti G, Rigon F. Insulin sensitivity in Turner’s syndrome: influence of GH treatment. Eur J Endocrinol 2004; 151(3): 351-4.
[] [PMID: 15362964]
Baronio F, Mazzanti L, Girtler Y, et al. The influence of GH treatment on glucose homeostasis in girls with Turner syndrome: a 7-year study. J Clin Endocrinol Metab 2017; 102(3): 878-83.
[PMID: 27911611]
Wooten N, Bakalov VK, Hill S, Bondy CA. Reduced abdominal adiposity and improved glucose tolerance in growth hormone-treated girls with Turner syndrome. J Clin Endocrinol Metab 2008; 93(6): 2109-14.
[] [PMID: 18349057]
Mazzanti L, Bergamaschi R, Castiglioni L, Zappulla F, Pirazzoli P, Cicognani A. Turner syndrome, insulin sensitivity and growth hormone treatment. Horm Res 2005; 64(Suppl. 3): 51-7.
[PMID: 16439845]
Bannink EM, van der Palen RL, Mulder PG, de Muinck Keizer-Schrama SM. Long-term follow-up of GH-treated girls with Turner syndrome: metabolic consequences. Horm Res 2009; 71(6): 343-9.
[PMID: 19506392]
Gravholt CH, Juul S, Naeraa RW, Hansen J. Morbidity in Turner syndrome. J Clin Epidemiol 1998; 51(2): 147-58.
[] [PMID: 9474075]
Mauras N, Shulman D, Hsiang HY, Balagopal P, Welch S. Metabolic effects of oral versus transdermal estrogen in growth hormone-treated girls with turner syndrome. J Clin Endocrinol Metab 2007; 92(11): 4154-60.
[] [PMID: 17711924]
Torres-Santiago L, Mericq V, Taboada M, et al. Metabolic effects of oral versus transdermal 17β-estradiol (E2): a randomized clinical trial in girls with Turner syndrome. J Clin Endocrinol Metab 2013; 98(7): 2716-24.
[] [PMID: 23678038]
Thomsen HH, Møller HJ, Trolle C, et al. The macrophage low-grade inflammation marker sCD163 is modulated by exogenous sex steroids. Endocr Connect 2013; 2(4): 216-24.
[] [PMID: 24148221]
Viuff MH, Berglund A, Juul S, Andersen NH, Stochholm K, Gravholt CH. Sex hormone replacement therapy in Turner syndrome: Impact on morbidity and mortality. J Clin Endocrinol Metab 2020; 105(2)dgz039
[] [PMID: 31545360]
Gravholt CH, Viuff MH, Brun S, Stochholm K, Andersen NH. Turner syndrome: mechanisms and management. Nat Rev Endocrinol 2019; 15(10): 601-14.
[] [PMID: 31213699]
Foudila T, Söderström-Anttila V, Hovatta O. Turner’s syndrome and pregnancies after oocyte donation. Hum Reprod 1999; 14(2): 532-5.
[] [PMID: 10100005]
Hagman A, Loft A, Wennerholm UB, et al. Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome: a Nordic cohort study. Hum Reprod 2013; 28(6): 1598-609.
[] [PMID: 23539610]
Karnis MF. Catastrophic consequences of assisted reproduction: the case of Turner syndrome. Semin Reprod Med 2012; 30(2): 116-22.
[] [PMID: 22549711]

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