Avaliação de parâmetros da composição corporal e da densidade mineral óssea em pacientes com Síndrome de Turner

Abstract

Introduction: Turner Syndrome (TS) results from the complete or partial absence of the second X chromosome and the most common characteristics are ovarian failure and short stature. Metabolic alterations and bone fragility have also been described. It is important to know the characteristics of body and bone composition in this population. Objective: To describe and evaluate the body composition and bone mineral density parameters of patients with Turner Syndrome followed up in the Endocrinology Department of the Walter Cantídio University Hospital. Methods: Observational, cross-sectional, descriptive, and quantitative study of adult TS patients aged over 20 years attending a tertiary center. The patients’ body and bone compositions were obtained by Lunar Prodigy Advance densitometry. Results: 46 patients were evaluated, median age 28 years, 54% monosomy, 28.3% X structural alteration and 17.4% mosaicism, 41% of whom were treated with GH (average duration of use 5.7 years). Pubertal induction occurred after the age of 13 in 35 (83%) patients. Only 4 (8.6%) had spontaneous menarche. All of them had received estrogen therapy at some stage in their lives. The frequency of overweight and obesity was 27% and 18%. The body composition of patients with TS differed significantly from women in the control group, when compared by age and body mass index (BMI), and greater trunk fat mass and android/gynoid ratio were observed in those with X structural alteration. Bone mineral density (BMD) varied directly with height. Low bone mass frequencies (lumbar and femoral) differed significantly in the sample, when calculated from BMD values (47.8% and 39.1%) or from apparent bone mineral density (BMAD) values (30 .4% and 13%). Conclusion: Patients with TS have an altered body composition when compared to the control group, and the android type was more observed in patients with X structural alteration. BMD correlates strongly with height and analysis by BMAD is more appropriate for the evaluation of bone mass in patients with a height of less than 150 cm.