Endocrine Abstracts

Introduction: Turner syndrome (TS) is associated with specific physical features, as well as a particular neuropsychological profile and social and behavioral features. It is common practice in the case of TS to treat short stature with growth hormone preparations and to induce puberty with estrogens at an age as close to normal puberty as possible. Nevertheless results of some studies show that despite the treatment, some women with TS still experience psychosocial problems, impaired cognitive functions and lower quality of life. The aim of the study was to analyze cognitive functions in adult women with Turner syndrome.

Methods: A total of 65 women with genetically confirmed TS≥18 yrs (age 30.2±9.0 years) and 65 age-matched healthy women (age 29.2±7.1 years, P=0.807) were recruited for the study. Cognitive functions were evaluated by Trail Making Test. Trail Making Test is a timed test in which the subject connects an altering sequence of numbers (Trail making A) or numbers and letters (Trail making B) in ascending order. The score on the Trail making A test, which is based on the time required to complete the sequence, is a measure of attention and visual scanning abilities. Trail making B is a test of executive function and psychomotor speed. A higher score denotes worse cognitive functioning. Sex hormones – Sex hormone-binding globulin (SHBG), Estradiol (E2), Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Dehydroepiandrosterone (DHEAS) and Testosterone (T) concentrations were measured in TS patients in the relationship with cognitive functions.

Results: Patients with TS were of a significantly shorter stature than age-matched control women (151.9±6.8 cm vs 167.4±5.9 cm, P<0.001). Trail Making A (42.7±17.4 vs 26.2±7.1, P=<0.001) and Trail Making B (86.0±30.6 vs 53.8±12.4, P=<0.001) showed worse cognitive functions in women with TS than in healthy age-matched women. Significant correlations between DHEAS (r=−0.442, P=0.006), T (r=−0.465, P=0.003) and Trail Making A test were found. The relation between T (r=−0.426, P=0.006), height (r=−0,355, P=0,019) and Trail Making B test in females with TS were identified, after adjusted for height the relation between T and Trail Making B remained insignificant (r=−0.1503, P=0.136). In conclusion, adult women with Turner syndrome have shorter stature and worse cognitive functions than age-matched healthy controls. The state of sex hormones and height in patients with Turner syndrome may be related with cognitive functions.