Increased detection of co-morbidities with evaluation at a dedicated adult Turner syndrome clinic. (3rd September 2017)

• Record Type: Journal Article
• Authors: Vincent, A. J.; Nguyen, H. H.; Ranasinha, S.; Vollenhoven, B.
• Is Part Of: Climacteric. Volume 20:Number 5(2017)
• Page Start: 442
• Page End: 447
• Publication Date: 2017-09-03
• Subjects: Turner syndrome -- morbidity -- hormone replacement therapy -- screening -- multi-disciplinary; Menopause -- Periodicals; Menopause -- Hormone therapy -- Periodicals; Menopause -- Periodicals; Estrogen Replacement Therapy -- Periodicals; Gynecology -- Periodicals; Societies, Medical -- Periodicals; 612.665
• DOI: 10.1080/13697137.2017.1350841
• Languages: English
• ISSNs: 1369-7137

Abstract

Abstract: Objectives: Turner syndrome (TS), resulting from complete/partial X chromosomal monosomy, is associated with multiple co-morbidities and increased mortality. Although multidisciplinary management is recommended, TS women's health care is sub-optimal. This study evaluates a multidisciplinary adult TS service. Methods: Retrospective cohort study of 82 patients attending the quarterly TS clinic from December 2003 to December 2014. Evaluation included (1) demographics, (2) TS standardized co-morbidity screening, and (3) estrogen therapy use. Data analysis involved frequency statistics, T tests and polychoric correlation analysis. Results: Median age at TS diagnosis was 14 years (range 0–65 years), with 12% of women aged >18 years. Median age at initial consultation was 31 years (range 16–65 years). Only 14% of patients were transition program referrals. XO karyotype occurred in 30%. Primary amenorrhea predominated; however, 37% of TS women were not taking estrogen therapy. The proportion of patients not previously screened (44–76%) and those with positive screening diagnoses (5–53%) varied according to co-morbidity. The mean (± standard deviation) number of co-morbidities identified increased following TS clinic screening (7.0 ± 2.6 post-screening vs. 4.4 ± 2.3 pre-screening; p < 0.0001). Polychoric correlation analysis identified particular co-morbidity groupings (including metabolism-related) and increased co-morbidities with primary amenorrhea. Conclusion: A multidisciplinary adult TS clinic improves health surveillance with increased identification of co-morbidities and initiation of estrogen therapy.