Long-term cortisol exposure tied to short stature, increased cholesterol in Turner syndrome
Chronic exposure to higher cortisol levels among patients with Turner syndrome (TS) is linked to short stature and greater total cholesterol levels, according to a study. Cortisol exposure also contributes to an increase in cardiovascular disease risk.
Patients with TS had higher hair cortisol concentrations (HCC; geometric mean, 3.51 pg/mg, 95 percent CI, 2.64–4.65 vs 2.39 pg/mg, 2.13–2.68; p=0.003) and a worse cardiometabolic profile in terms of fasting glucose and triglycerides compared with controls.
HCC correlated with total cholesterol levels (standardized β, 0.294; p=0.047) but not with psychological outcomes. In addition, an inverse association was found between a higher HCC and height in patients with TS (standardized β, –0.307; p=0.023).
This prospective, observational case-control study conducted at an academic outpatient TS expertise centre determined whether TS was associated with increased long-term cortisol concentrations as measured in scalp hair and whether these were linked to cardiometabolic and psychological parameters.
The investigators identified 55 patients with TS (53 percent 45,X karyotype) and 110 age-matched female community control individuals from the general population-based Lifelines cohort study. The outcome measures included HCC, anthropometrics, biochemical parameters, and psychological questionnaires for perceived stress (Perceived Stress Scale–14), fatigue (Checklist Individual Strength–20) and health-related quality of life (RAND-36).
“TS usually manifests in traits as short stature and premature ovarian failure,” the investigators said. “Many patients also have an increased risk of cardiometabolic disorders and psychological distress, which are features that overlap with those of a prolonged state of hypercortisolism.”