ECE2018 Poster Presentations: Reproductive Endocrinology Cardiovascular Endocrinology and Lipid Metabolism (2 abstracts)
Mater Misericordiae University Hospital, Dublin, Ireland.
Turner Syndrome (TS) is a genetic disorder which affects 0.51 in every 2000 females. It is a multi-systemic disease characterised by a deleted or partially missing X chromosome. This deletion results in a higher incidence of primary ovarian failure and removal of the cardio-protective presence of endogenous oestrogen. The aim of this study was to analyse the prevalence of cardiovascular risk factors in a TS cohort and to assess the steps taken to modify these risk factors. We retrospectively analysed the charts of 54 TS patients attending a university hospital endocrinology clinic. Data was collected on blood pressure (BP), lipid and Haemoglobin A1c profiles, statin and hormone replacement therapy (HRT) use, Body Mass Index (BMI), and the presence of structural heart disease. Data is expressed as mean±S.D. We aimed to assess the number of patients who reached targets of blood pressure (BP) less than 140/90 mmHg; BMI <25 kg/m2 and Low density lipoprotein (LDL) less than 2.6 mmol/l. Fifty four patients with mean age of 35.1±12.6 years had BMI of 28.54±8.11 kg/m2; 19 patients had a BMI within target. Mean BP was 121.6±13.3/73.7±10.5 mmHg. Twelve patients were on anti-hypertensive agents (eight patients were on single agent treatment and four were taking two agents). Mean BP of those not on anti-hypertensive therapy was 117.3±12.2/72.2±10.5 mmHg. Seven patients did not have blood pressure within target. Mean LDL level was 2.95±1.31 mmol/l with mean total cholesterol of 5.11±2.62 mmol/l. Only 12 out of 54 (22%) of patients achieved their LDL targets. Seven patients were on therapy while a further four declined therapy. Mean LDL of those on therapy (6 on statin therapies; one on ezetimibe) was 3.4±0.6 mmol/l. One patient on statin therapy achieved the target LDL. Mean HbA1c for the cohort was 34±3.6 mmol/mol. Four patients had impaired glucose tolerance (IGT). Three patients had confirmed type 2 Diabetes Mellitus (T2DM) with mean HbA1c of 54.0±9.9 mmol/mol. Fourteen patients were not taking hormone replacement therapy; six patients were post-menopausal, three patients desired pregnancy, three patients had spontaneous menstruation, one patient declined therapy and one patient had severe liver disease. In summary, while the majority of patients in our cohort have a blood pressure within our recommended targets a significant number are above both their BMI and LDL targets. Further efforts will be concentrated on improving these metabolic goals.