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Hypothyroidism Is Common in Turner Syndrome: Results of a Five-Year Follow-Up

Endocrine Division (M.E.-M., K.L.-W.), Departments of Internal Medicine, and Obstetrics and Gynecology (I.B., C.H.), Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; Department of Endocrinology (K.B.), Malmö University Hospital, Lund University, SE-20502 Malmö, Sweden; and Section of Preventive Cardiology (L.W.), Göteborg University, SE-41250 Göteborg, Sweden

Address all correspondence and requests for reprints to: Kerstin Landin-Wilhelmsen, M.D., Ph.D., Endocrine Division, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. E-mail: kerstin.landin{at}sahlgrenska.se.

Turner syndrome (TS) is caused by a sex chromosome aberration. The aim was to study the prevalence and incidence of thyroid disease in adults with TS.

Women with TS (n = 91; mean age, 37.7 ± 11 yr) were compared with an age-matched female random population sample (n = 228). At baseline, 15 (16%) TS women were treated for hypothyroidism, and elevated serum TSH was found in another eight (9%). As a result, hypothyroidism was more common in women with TS (25%) than in controls (2%; P < 0.0001). Serum free T₄ was lower (P = 0.02), and serum TSH was higher (P < 0.0001) in TS women than in age-matched controls. Of all TS women with hypothyroidism, 10 (43%) had an elevated thyroid peroxidase antibody titer vs. 15 (22%) of those without hypothyroidism (P < 0.05), evenly distributed between the karyotype 45,X and mosaicism. A high body mass index, but not a family history or blood lipids, was associated with hypothyroidism in TS. After the 5-yr follow-up, an additional 11 (16%) developed hypothyroidism, of whom four (36%) had elevated thyroid peroxidase. Altogether, 34 (37%) TS women had hypothyroidism after the 5-yr follow-up.

Autoimmune hypothyroidism was common, with an annual incidence of 3.2% in TS. Thyroid function should be checked regularly in TS.

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