There is a wide spectrum of skin anomalies in TS related to fetal lymphoedema, GH therapy or elevated FSH level. AN is characterized by hyperkeratosis, pigmentation and small papillomatous elevation of the skin. Aim of the study: to evaluate the association between TS, AN and glucose-tolerance. Methods: 129 TS pts (45,X=43%; X-SA=41%; X-mosaicism=13%; Ymosaicism=3%) were studied for glucose tolerance and skin anomalies. All pts had GH-therapy (range3-12 yrs) alone or with EE-P. Beta-cell function and insulin sensitivity (IS) were studied with indices from fasting or OGTT (0,30,60,120’); beta-cell function: HOMA, insulinogenic (II) 30’, II-120’ indices; IS: fasting glucose to insulin ratio, HOMA IR, HOMA IS indices. Results: 13 pts (10%) showed AN (karyotype: 7 pts=45,X; 5 pts=X-SA and 1 pt=X-mosaicism). Age of GH-onset and duration were the same in pts with and without AN.GH therapy, according to its duration, determines a lowering of betacell function (HOMA p=0.048; II-120’ p=0.0002) and an increase of fasting glucose to insulin ratio. Age influences negatively HOMA IS (p=0.0001). Age(p=0.006) and BMI(p=0.04) correlated positively with II-120. There were no differences in glucose values (fasting and after OGTT) in pts with and without AN. AN pts had higher values of acute and complete serum insulin levels (II-30’ p=0.001; II-120’ p=0.019) and higher HOMA IR (p=0.02). Karyotype (45,X presence) influences the appearance of AN (p=0.008). Discussion: AN pts showed mean insulin level (fasting and after OGTT) significantly higher than pts without AN. The insulin AUC is greater in AN pts, but there were no differences in glucose AUC in pts with and without AN. Probably AN pts may need a higher production of insulin to keep glucose values within the normal range. This is the expression of insulin resistance, in fact HOMA IR is significantly higher in AN pts. GH therapy, according to its duration, does not influence betacell function in AN pts.
Acanthosis Nigricans (AN), Glucose Tolerance and Turner Syndrome: Influence of GH-Therapy
BERGAMASCHI, ROSALBA;MAZZANTI, LAURA;STROCCHI, SIMONA;ROSETTI, VALENTINA;CASTIGLIONI, LAURA;ZAPPULLA, FRANCO;CICOGNANI, ALESSANDRO;CACCIARI, EMANUELE
2004
Abstract
There is a wide spectrum of skin anomalies in TS related to fetal lymphoedema, GH therapy or elevated FSH level. AN is characterized by hyperkeratosis, pigmentation and small papillomatous elevation of the skin. Aim of the study: to evaluate the association between TS, AN and glucose-tolerance. Methods: 129 TS pts (45,X=43%; X-SA=41%; X-mosaicism=13%; Ymosaicism=3%) were studied for glucose tolerance and skin anomalies. All pts had GH-therapy (range3-12 yrs) alone or with EE-P. Beta-cell function and insulin sensitivity (IS) were studied with indices from fasting or OGTT (0,30,60,120’); beta-cell function: HOMA, insulinogenic (II) 30’, II-120’ indices; IS: fasting glucose to insulin ratio, HOMA IR, HOMA IS indices. Results: 13 pts (10%) showed AN (karyotype: 7 pts=45,X; 5 pts=X-SA and 1 pt=X-mosaicism). Age of GH-onset and duration were the same in pts with and without AN.GH therapy, according to its duration, determines a lowering of betacell function (HOMA p=0.048; II-120’ p=0.0002) and an increase of fasting glucose to insulin ratio. Age influences negatively HOMA IS (p=0.0001). Age(p=0.006) and BMI(p=0.04) correlated positively with II-120. There were no differences in glucose values (fasting and after OGTT) in pts with and without AN. AN pts had higher values of acute and complete serum insulin levels (II-30’ p=0.001; II-120’ p=0.019) and higher HOMA IR (p=0.02). Karyotype (45,X presence) influences the appearance of AN (p=0.008). Discussion: AN pts showed mean insulin level (fasting and after OGTT) significantly higher than pts without AN. The insulin AUC is greater in AN pts, but there were no differences in glucose AUC in pts with and without AN. Probably AN pts may need a higher production of insulin to keep glucose values within the normal range. This is the expression of insulin resistance, in fact HOMA IR is significantly higher in AN pts. GH therapy, according to its duration, does not influence betacell function in AN pts.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
