Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep 9:12:1795-1809.
doi: 10.2147/DMSO.S214787. eCollection 2019.

Anthropometric variables as cardiovascular risk predictors in a cohort of adult subjects with Turner syndrome

Francisco Álvarez-Nava  1   2 , Marcia Racines  3 , Julia Witt  1 , Jéssica Guarderas  1 , María Estévez  3   4 , Roberto Lanes  5
Affiliations

Anthropometric variables as cardiovascular risk predictors in a cohort of adult subjects with Turner syndrome

Francisco Álvarez-Nava et al. Diabetes Metab Syndr Obes. .

Abstract

Background and purpose: Excessive adiposity is associated with cardiometabolic complications in Turner syndrome (TS) subjects. Reference data for predictive anthropometric indices of overweight/obesity and metabolic syndrome (MetS) are lacking for subjects with TS. The purpose of this study was to identify the best anthropometric predictor of cardiometabolic risk in a Latin-American cohort of TS subjects.

Patients and methods: This was a cross-sectional correlational study conducted in adult TS subjects (n=88) over the past seven years. Anthropometric parameters, body composition and biochemical variables were evaluated in a study and in a reference (n=57) group. Overweight/obesity and MetS were diagnosed using international consensus. The area under the ROC curve (AUC-ROC) was then used to determine the value of each anthropometric variable in predicting MetS or overweight/obesity.

Results: The prevalence of MetS and overweight/obesity in TS subjects was 40% and 48%, respectively. All anthropometric and cardiometabolic variables were significantly increased in TS subjects when compared to the reference group, except for body mass index (BMI) and HDL-c. To detect MetS and overweight/obesity, waist to height ratio (WHtR) was found to have a higher correlation with cardiometabolic variables (TC, LDL-c, HDL-c levels and the LDL-c/HDL-c ratio), and to have a higher AUC-ROC and odds ratio than BMI, waist circumference (WC) and the waist to hip ratio (WHR).

Conclusion: The prevalence of MetS and overweight/obesity is elevated in TS subjects. WHtR was the most useful variable in predicting the presence of MetS and overweight and obesity in this TS cohort. A combination of WHtR with BMI or with WC could have the best clinical utility in identifying adult TS subjects with overweight/obesity and MetS, respectively.

Keywords: Turner syndrome; anthropometric indexes; body composition; cardiometabolic risk; metabolic syndrome; obesity; overweight.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have nothing to disclose and there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

Figure 1
Figure 1
Prevalence of the single components of MetS for TS subject and reference groups. Notes: Prevalence expressed in % (95% CI). *Significant difference between both groups (two proportion Z-test). Abbreviations: HTA, Arterial Hypertension; Pathological WC, Waist Circumference ≥80 cm.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for prediction of Metabolic Syndrome (MetS) from waist-to-height ratio (WHtR), waist circumference, waist-to-hip ratio (WHR) and body mass index (BMI) in adult Turner syndrome subjects.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve for prediction of Overweight/Obesity from waist-to-height ratio (WHtR), waist circumference, waist-to-hip ratio (WHR) and body mass index (BMI) in adult Turner syndrome subjects.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Álvarez-Nava F, Soto M, Sánchez MA, Fernández E, Lanes R. Molecular analysis in Turner syndrome. J Pediatr. 2003;142:336–340. doi:10.1067/mpd.2003.95 - DOI - PubMed
    1. 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:G1–G70. doi:10.1530/EJE-17-0430 - DOI - PubMed
    1. Baldin AD, Armani MC, Morcillo AM, et al. Body proportions in a group of Brazilian patients with Turner syndrome. Arq Bras Endocrinol Metabol. 2005;49:529–535. doi:10.1590/S0004-27302005000400010 - DOI - PubMed
    1. 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;155:583–592. doi:10.1530/eje.1.02267 - DOI - PubMed
    1. Holl RW, Kunze D, Etzrodt H, et al. Turner syndrome: final height, glucose tolerance, bone density and psychosocial status in 25 adult patients. Eur J Pediatr. 1994;153:11. doi:10.1007/BF02000780 - DOI - PubMed