Vasculopathy in the Young Turner Syndrome Population

Abstract

CONTEXT: Turner syndrome (TS) carries an increased risk for vascular disease, or vasculopathy. OBJECTIVE: Vasculopathy can be detected in young TS patients. DESIGN AND PATIENTS: Vasculopathy was prospectively assessed by measuring vascular function and structure in TS patients (n = 49) and lean (L) (n = 76) and obese (O) controls (n = 52) through noninvasive techniques. Controls were drawn from previously known adolescents who were age-matched and disease-free. DATA COLLECTED: Pulse wave velocity femoral (PWVf), augmentation index (AIx), carotid intima media thickness (cIMT), and Young's Elastic Modulus (YEM). RESULTS: Mean age and body mass index (BMI) for TS, L, and O subjects were 11.89 years and 21.2 kg/m(2), 17.93 years and 20.9 kg/m(2), and 18.35 years 36.5 kg/m(2), respectively. Blood pressure means (mmHg) in TS, L, and O subjects were 112/65, 103/59, and 113/67, respectively. A greater AIx and YEM were seen in TS patients after adjusting for age plus BMI: AIx = 12.3% ± 2 (TS), -2% ± 1.7 (L), 5.8% ± 2.2 (O); YEM = 544.4 mmHg/mm ± 26.75 (TS), 258.1 mmHg/mm ± 22.7 (L), 343.5 mmHg/mm ± 30.6 (O). After adjustment for age and BMI, a greater PWVf was seen in TS vs L controls (P < .0001). The cIMT was lowest in the TS group: 0.35 mm ± 0.06 vs 0.43 mm ± 0.06 (L) and 0.45 mm ± 0.06 (O) (P < .001). CONCLUSIONS: Vasculopathy, a marker of cardiovascular morbidity in adult TS, is detected in childhood. The findings remained after adjusting for age, demonstrating stiffer arterial vessels in young TS patients.