Abstract
In 6 untreated patients with TS [mean age (MA)=18.3±2.29 yr, mean body mass index (MBMI)=21.5±0.75 kg/m2], mean plasma glucose during an OGTT was significantly higher at 120 min (p<0.05) than in 6 female controls [MA=27.2±1.54 yr, MBMI=20.9±0.78 kg/m2 (p=NS vs TS)]. This occurred despite a higher mean insulin concentration at 120 min and a higher mean integrated insulin response in TS (both p<0.05 vs controls). To document the presence of presumed IR, we measured insulin sensitivity in vitro by the EPC assay. EPC showed a mean proliferative response of only 60.0±11.6% above baseline in TS vs 95.0±4.65% for normal females (p<0.01). We have previously reported a much greater reduction in EPC response (26.7±9.11% above baseline)in obese hyperinsulinemic subjects with more severe insulin resistance. In an attempt to localize the site of IR in TS patients, insulin receptor binding of peripheral monocytes was examined. Binding in TS was heterogeneous with 4 subjects manifesting normal binding while the other 2 had diminished binding sites. Binding did not correlate with in vitro insulin sensitivity.
In summary, abnormal disposal of oral glucose occurs in TS. This appears to be due to IR as shown by the sensitive in vitro EPC assay system in which diminished EPC proliferation occurred in response to added insulin.
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Geffner, M., Kaplan, S., Bersch, N. et al. INSULIN RESISTANCE (IR) IN TURNER SYNDROME (TS): DETECTION BY DIMINISHED IN VITRO RESPONSE OF ERYTHROCYTE PROGENITOR CELLS (EPC) TO INSULIN. Pediatr Res 18 (Suppl 4), 292 (1984). https://doi.org/10.1203/00006450-198404001-01202
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DOI: https://doi.org/10.1203/00006450-198404001-01202