Insulin Sensitivity in Patients with Turner´s Syndrome

ARCARI A; KESELMAN A; BALLERINI M; GRYNGARTEN M; ROPELATO M; BERGADÁ I; GRUÑEIRO- PAPENDIECK L; ESCOBAR M

Lima, Perú

Congreso; XX Annual Meeting of the Sociedad Latinoamericana de Endocrinología Pediátrica.; 2008

Turner´s Syndrome (TS) is associated with decreased insulin sensitivity (IS) and increased risk of Type II Diabetes (DBT). The aim of the present study was to determine the prevalence of impaired of IS in girl with TS in relation to Tanner stage (T), GH therapy and sexual steroid replacement. Fifty three were studied. We analyzed body mass index (BMI), glycemia (G), insulin (I) by ICMA, area under curve (AUC) of G and I with an oral glucose tolerance test (OGTT) and assessed insulin sensitivity by HOMA, QUICKI, G/I index. Patients were divided into groups according T and GH therapy: A1: (n=8) TI without GH, A2 (n=10) TII-IV without GH, B1 (n=17) TI with GH, B2 (n=6) TII-IV with GH and C (n=12) TV with previous GH treatment. Groups were compared with prepubertal (PP, n=46) and pubertal (P, n=59) controls. No patients had Type II DBT, only one patient with morbid obesity (C) had G intolerance. GH patients (B1 and B2) had lower BMI than patients without GH, (A1, p=0.01 and A2, p=0.04). Prepubertal patients with GH therapy (B1) had higher I and lower G/I index than controls (PP), p<0.05. There were no differences among pubertal patients with and without GH, when compared to controls. BMI had positive correlations with I SDS, QUICKI, HOMA, G/I index and AUC I. Conclusion: GH therapy induces alterations in IS, in prepubertal girls with TS but this treatment does not increase the degree of insulin resistance normally observed during puberty.