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

Abstract

Francisco Álvarez-Nava1,2, Marcia Racines3, Julia Witt1, Jéssica Guarderas1, María Estévez3,4, Roberto Lanes5 1Biological Sciences School, Faculty of Biological Sciences, Central University of Ecuador, Quito, Ecuador; 2Genetic Research Institute, University of Zulia, Maracaibo, Venezuela; 3Institute of Biomedicine Research, Central University of Ecuador; Quito, Ecuador; 4Ecuadorian Foundation in Support of Turner Syndrome, Quito, Ecuador; 5Pediatric Endocrine Unit, Hospital de Clinicas Caracas, Caracas, VenezuelaCorrespondence: Francisco Álvarez-NavaBiological Sciences School, Faculty of Biological Sciences, Central University of Ecuador, Calle Iquique con Calle Sodiro Number N14-121, Parroquia San Blas, Quito, Pichincha 170113, EcuadorTel [phone]Fax [phone]Email [email protected] 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: anthropometric indexes, body composition, cardiometabolic risk, metabolic syndrome, obesity, overweight, Turner syndrome

Keywords

• Anthropometric indexes
• body composition
• cardiometabolic risk
• metabolic syndrome
• obesity
• overweight
• Turner syndrome