{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:40:05Z","timestamp":1780760405408,"version":"3.54.1"},"reference-count":110,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Turner syndrome (TS) is a common chromosomal disorder resulting from complete or partial absence of the second sex chromosome. Hyperglycemia, ranging from impaired glucose tolerance (IGT) to diabetes mellitus (DM), is common in TS. DM in individuals with TS is associated with an 11-fold excess in mortality. The reasons for the high prevalence of hyperglycemia in TS are not well understood even though this aspect of TS was initially reported almost 60 years ago. Karyotype, as a proxy for X chromosome (X<jats:sub>chr<\/jats:sub>) gene dosage, has been associated with DM risk in TS \u2013 however, no specific X<jats:sub>chr<\/jats:sub> genes or loci have been implicated in the TS hyperglycemia phenotype. The molecular genetic study of TS-related phenotypes is hampered by inability to design analyses based on familial segregation, as TS is a non-heritable genetic disorder. Mechanistic studies are confounded by a lack of adequate TS animal models, small and heterogenous study populations, and the use of medications that alter carbohydrate metabolism in the management of TS. This review summarizes and assesses existing data related to the physiological and genetic mechanisms hypothesized to underlie hyperglycemia in TS, concluding that insulin deficiency is an early defect intrinsic to TS that results in hyperglycemia. Diagnostic criteria and therapeutic options for treatment of hyperglycemia in TS are presented, while emphasizing the pitfalls and complexities of studying glucose metabolism and diagnosing hyperglycemia in the TS population.<\/jats:p>","DOI":"10.3389\/fendo.2023.1116889","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T05:59:36Z","timestamp":1676440776000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Hyperglycemia in Turner syndrome: Impact, mechanisms, and areas for future research"],"prefix":"10.3389","volume":"14","author":[{"given":"Cameron","family":"Mitsch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirene","family":"Alexandrou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Norris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherina T.","family":"Pinnaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra030360","article-title":"Turner's syndrome","volume":"351","author":"Sybert","year":"2004","journal-title":"New Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0430","article-title":"Clinical practice guidelines for the care of girls and women with turner syndrome: Proceedings from the 2016 Cincinnati international turner syndrome meeting","volume":"177","author":"Gravholt","year":"2017","journal-title":"Eur J Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-017-1336-z","article-title":"New insights on diabetes in turner syndrome: Results from an observational study in adulthood","volume":"59","author":"Ibarra-Gasparini","year":"2018","journal-title":"Endocrine"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-1049","article-title":"Mortality in women with turner syndrome in great Britain: A national cohort study","volume":"93","author":"Schoemaker","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1017\/s0003480001008569","article-title":"Mortality and cancer incidence in persons with numerical sex chromosome abnormalities: A cohort study","volume":"65","author":"Swerdlow","year":"2001","journal-title":"Ann Hum Genet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1136\/jech.40.2.97","article-title":"Mortality ratios, life expectancy, and causes of death in patients with turner's syndrome","volume":"40","author":"Price","year":"1986","journal-title":"J Epidemiol Community Health"},{"key":"B7","article-title":"The high incidence of diabetes mellitus in 41 patients with gonadal dysgenesis, and their close relatives","volume":"12","author":"Forbes","year":"1963","journal-title":"Metabol: Clin Exp"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2337\/diab.28.12.1039","article-title":"Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. national diabetes data group","volume":"28","author":"Harris","year":"1979","journal-title":"Diabetes"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-S005","article-title":"American Diabetes Association. The classification and diagnosis of diabetes","year":"2016","journal-title":"Diabetes Care"},{"key":"B10","first-page":"202","volume-title":"Joslin\u2019s diabetes mellitus","author":"Marble","year":"1971"},{"key":"B11","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/0021-9681(61)90041-8","article-title":"The efficiency of screening tests for diabetes","volume":"13","author":"Remein","year":"1961","journal-title":"J Chronic Dis"},{"key":"B12","article-title":"WHO study group. Diabetes Mellitus","volume":"727","year":"1985","journal-title":"WHO Tech Rep Ser"},{"key":"B13","first-page":"S1","article-title":"Canadian Diabetes association 2008 clinical practice guidelines for the prevention and management of diabetes in Canada","volume":"32","author":"Committee","year":"2008","journal-title":"Can J Diabetes"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1677\/joe.0.0340289","article-title":"Carbohydrate metabolism and pituitary function in gonadal dysgenesis (Turner's syndrome)","volume":"34","author":"Jackson","year":"1966","journal-title":"J Endocrinol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80627-5","article-title":"Carbohydrate intolerance in children and adolescents with turner syndrome","volume":"96","author":"Polychronakos","year":"1980","journal-title":"J Pediatr"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/bf00441818","article-title":"Differences in carbohydrate tolerance in turner syndrome depending on age and karyotype","volume":"148","author":"Cicognani","year":"1988","journal-title":"Eur J Pediatr"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1159\/000180104","article-title":"Carbohydrate intolerance in gonadal dysgenesis: Evidence for insulin resistance and hyperglucagonemia","volume":"22","author":"Costin","year":"1985","journal-title":"Hormone Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/bf02000780","article-title":"Turner syndrome: Final height, glucose tolerance, bone density and psychosocial status in 25 adult patients","volume":"153","author":"Holl","year":"1994","journal-title":"Eur J Pediatr"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1159\/000089318","article-title":"Turner syndrome, insulin sensitivity and growth hormone treatment","author":"Mazzanti","year":"2005","journal-title":"Hormone Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.7.1062","article-title":"Glucose metabolism, lipid metabolism, and cardiovascular risk factors in adult turner's syndrome","volume":"21","author":"Gravholt","year":"1998","journal-title":"Impact Sex Hormone Replacement Diabetes Care"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(88)80057-x","article-title":"Carbohydrate and lipid metabolism in turner syndrome: Effect of therapy with growth hormone, oxandrolone, and a combination of both","volume":"112","author":"Wilson","year":"1988","journal-title":"J Pediatr"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.2.6334","article-title":"Carbohydrate metabolism during long-term growth hormone (Gh) treatment and after discontinuation of gh treatment in girls with turner syndrome participating in a randomized dose-response study","volume":"85","author":"Sas","year":"2000","journal-title":"Dutch Advisory Group Growth Hormone J Clin Endocrinol Metab"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-020789","article-title":"Effect of discontinuation of long-term growth hormone treatment on carbohydrate metabolism and risk factors for cardiovascular disease in girls with turner syndrome","volume":"87","author":"Van Pareren","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"B24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/s0026-0495(99)90003-3","article-title":"Carbohydrate and lipid metabolism during various growth hormone dosing regimens in girls with turner syndrome","volume":"48","author":"van Teunenbroek","year":"1999","journal-title":"Dutch Working Group Growth Hormone Metabol: Clin Exp"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0671","article-title":"Metabolic effects of oral versus transdermal estrogen in growth hormone-treated girls with turner syndrome","volume":"92","author":"Mauras","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.586055","article-title":"Increased insulin concentrations during growth hormone treatment in girls with turner syndrome are ameliorated by hormone replacement therapy","volume":"11","author":"Segerer","year":"2020","journal-title":"Front Endocrinol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2005.02270.x","article-title":"Effect of growth hormone and 17beta-oestradiol treatment on metabolism and body composition in girls with turner syndrome","volume":"62","author":"Gravholt","year":"2005","journal-title":"Clin Endocrinol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2019-317695","article-title":"Effect of oxandrolone and timing of pubertal induction on final height in turner syndrome: Final analysis of the uk randomised placebo-controlled trial","volume":"106","author":"Gault","year":"2021","journal-title":"Arch Dis Childhood"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1159\/000319313","article-title":"Effect of oxandrolone on glucose metabolism in growth hormone-treated girls with turner syndrome","volume":"75","author":"Menke","year":"2011","journal-title":"Hormone Res Paediatrics"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000023505","article-title":"Effect of growth hormone and oxandrolone treatment on glucose metabolism in turner syndrome","volume":"53","author":"Joss","year":"2000","journal-title":"A Longitudinal Study Hormone Res"},{"key":"B31","author":"Cowie","year":"2018"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0384","article-title":"X-Chromosome gene dosage and the risk of diabetes in turner syndrome","volume":"94","author":"Bakalov","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(79)90813-5","article-title":"Carbohydrate tolerance in gonadal dysgenesis","volume":"135","author":"Van Campenhout","year":"1979","journal-title":"Am J Obstet Gynecol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-005-1643-x","article-title":"The abnormalities of carbohydrate metabolism in turner syndrome: Analysis of risk factors associated with impaired glucose tolerance","volume":"164","author":"Choi","year":"2005","journal-title":"Eur J Pediatr"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1966","article-title":"Adipokine dysregulation in turner syndrome: Comparison of circulating interleukin-6 and leptin concentrations with measures of adiposity and c-reactive protein","volume":"90","author":"Ostberg","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1939","article-title":"Excess visceral and hepatic adipose tissue in turner syndrome determined by magnetic resonance imaging: Estrogen deficiency associated with hepatic adipose content","volume":"90","author":"Ostberg","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1089\/met.2013.0075","article-title":"Metabolic syndrome in turner syndrome and relation between body composition and clinical, genetic, and ultrasonographic characteristics","volume":"12","author":"Calcaterra","year":"2014","journal-title":"Metab Syndrome Rel Disord"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.S214787","article-title":"Anthropometric variables as cardiovascular risk predictors in a cohort of adult subjects with turner syndrome","volume":"12","author":"\u00c1lvarez-Nava","year":"2019","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320420405","article-title":"Fat distribution in overweight patients with ullrich-turner syndrome","volume":"42","author":"Hanaki","year":"1992","journal-title":"Am J Med Genet"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320460421","article-title":"Assessment of subcutaneous fat using ultrasonography in the ullrich-turner syndrome","volume":"46","author":"Ohzeki","year":"1993","journal-title":"Am J Med Genet"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02267","article-title":"Body composition is distinctly altered in turner syndrome: Relations to glucose metabolism, circulating adipokines, and endothelial adhesion molecules","volume":"155","author":"Gravholt","year":"2006","journal-title":"Eur J Endocrinol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1096-8628(19971112)72:4<403::aid-ajmg6>3.0.co;2-r","article-title":"Reference values for body proportions and body composition in adult women with ullrich-turner syndrome","volume":"72","author":"Gravholt","year":"1997","journal-title":"Am J Med Genet"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00027","article-title":"The natural history of metabolic comorbidities in turner syndrome from childhood to early adulthood: Comparison between 45,X monosomy and other karyotypes","volume":"9","author":"Lebenthal","year":"2018","journal-title":"Front Endocrinol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1016\/s0140-6736(66)90286-8","article-title":"Gonadal dysgenesis and diabetes","volume":"1","author":"Menzinger","year":"1966","journal-title":"Lancet"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1038\/221175a0","article-title":"Klinefelter's syndrome, dizygotic twinning and diabetes mellitus","volume":"221","author":"Burch","year":"1969","journal-title":"Nature"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/bf00394004","article-title":"Diabetes mellitus in patients with aneuploid chromosome aberrations and in their parents","volume":"16","author":"Nielsen","year":"1972","journal-title":"Humangenetik"},{"key":"B47","article-title":"The occurrence of abnormal insulin and growth hormone (Hgh) responses to sustained hyperglycaemia in a disease with sex chromosome aberrations (Turner's syndrome)","volume":"56","author":"Lindsten","year":"1967","journal-title":"Including Histol Study Pancreas Two Such Patients Acta Endocrinol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1046\/j.1365-2265.2004.01971.x","article-title":"The prevalence of diabetes mellitus in the parents of women with turner's syndrome","volume":"60","author":"Bakalov","year":"2004","journal-title":"Clin Endocrinol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1007\/s00439-014-1519-0","article-title":"Genetic and environmental components of family history in type 2 diabetes","volume":"134","author":"Cornelis","year":"2015","journal-title":"Hum Genet"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1210\/er.2012-1055","article-title":"The role of estrogens in control of energy balance and glucose homeostasis","volume":"34","author":"Mauvais-Jarvis","year":"2013","journal-title":"Endocrine Rev"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-138-1-200301070-00005","article-title":"Glycemic effects of postmenopausal hormone therapy: The heart and Estrogen\/Progestin replacement study","volume":"138","author":"Kanaya","year":"2003","journal-title":"A Randomized Double-Blind Placebo-Controlled Trial Ann Internal Med"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-004-1448-x","article-title":"Effect of oestrogen plus progestin on the incidence of diabetes in postmenopausal women: Results from the women's health initiative hormone trial","volume":"47","author":"Margolis","year":"2004","journal-title":"Diabetologia"},{"key":"B53","first-page":"279","article-title":"Classic pages in obstetrics and gynecology by Henry h. turner. a syndrome of infantilism, congenital webbed neck, and cubitus valgus. endocrinology, vol. 23, pp. 566-574, 1938","volume":"113","author":"Turner","year":"1972","journal-title":"Am J Obstet Gynecol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1159\/000520233","article-title":"Increased prevalence of beta-cell dysfunction despite normal Hba1c in youth and young adults with turner syndrome","volume":"94","author":"Sheanon","year":"2021","journal-title":"Hormone Res Paediatrics"},{"key":"B55","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.molmet.2018.04.003","article-title":"Sex differences in obesity, lipid metabolism, and inflammation-a role for the sex chromosomes","volume":"15","author":"Zore","year":"2018","journal-title":"Mol Metab"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05040-3","article-title":"Sex differences in metabolic regulation and diabetes susceptibility","volume":"63","author":"Tramunt","year":"2020","journal-title":"Diabetologia"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3181c684b2","article-title":"Laboratory guideline for turner syndrome","volume":"12","author":"Wolff","year":"2010","journal-title":"Genet Med Off J Am Coll Med Genet"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13394","article-title":"The turner syndrome life course project: Karyotype-phenotype analyses across the lifespan","volume":"87","author":"Cameron-Pimblett","year":"2017","journal-title":"Clin Endocrinol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0122","article-title":"Impaired insulin secretion in the turner metabolic syndrome","volume":"89","author":"Bakalov","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"B60","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1530\/eje-18-0878","article-title":"Leger J","volume":"180","author":"Fiot","year":"2019","journal-title":"X Chromosome Gene Dosage as Determinant Congenital Malformations Age-Related Comorbid Risk Patients Turner Syndrome Childhood to Early Adulthood Eur J Endocrinol"},{"key":"B61","article-title":"Genomic imprinting and turner syndrome","author":"Bondy","year":"2012","journal-title":"Pediatr Endocrinol Rev"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2020-0104","article-title":"Impact of parental origin of X-chromosome on clinical and biochemical profile in turner syndrome","volume":"33","author":"Malhotra","year":"2020","journal-title":"J Pediatric Endocrinology Metab"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.5507\/bp.2020.060","article-title":"Haplotype analysis of the X chromosome in patients with turner syndrome in order to verify the possible effect of imprinting on selected symptoms","volume":"166","author":"Vrtel","year":"2022","journal-title":"BioMed Pap Med Fac Univ Palacky Olomouc Czech Repub"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0503","article-title":"Monosomy for the X-chromosome is associated with an atherogenic lipid profile","volume":"91","author":"Van","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.12.1373","article-title":"Maternal X chromosome, visceral adiposity, and lipid profile","volume":"295","author":"Van","year":"2006","journal-title":"Jama"},{"key":"B66","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s13148-015-0112-2","article-title":"DNA Methylation signature in peripheral blood reveals distinct characteristics of human X chromosome numerical aberrations","volume":"7","author":"Sharma","year":"2015","journal-title":"Clin Epigenet"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1038\/srep34220","article-title":"Widespread DNA hypomethylation and differential gene expression in turner syndrome","volume":"6","author":"Trolle","year":"2016","journal-title":"Sci Rep"},{"key":"B68","doi-asserted-by":"publisher","first-page":"e100076","DOI":"10.1371\/journal.pone.0100076","article-title":"Human 45,X fibroblast transcriptome reveals distinct differentially expressed genes including long noncoding rnas potentially associated with the pathophysiology of turner syndrome","volume":"9","author":"Rajpathak","year":"2014","journal-title":"PloS One"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1515\/hmbci-2020-0076","article-title":"Ppargc1a promoter DNA-methylation level and glucose metabolism in Ecuadorian women with turner syndrome","volume":"42","author":"\u00c1lvarez-Nava","year":"2020","journal-title":"Horm Mol Biol Clin Investig"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.2174\/13816128113199990518","article-title":"Evidence for epigenetic alterations in turner syndrome opens up feasibility of new pharmaceutical interventions","volume":"20","author":"Rajpathak","year":"2014","journal-title":"Curr Pharm Design"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000029069","article-title":"Investigation of hub genes involved in turner syndrome using biological informatics methods","volume":"101","author":"Cheng","year":"2022","journal-title":"Med (Baltimore)"},{"key":"B72","doi-asserted-by":"publisher","first-page":"10662","DOI":"10.1038\/s41598-021-90171-0","article-title":"Network-based analysis of key regulatory genes implicated in type 2 Diabetes Mellitus and recurrent miscarriages in turner syndrome","volume":"11","author":"Farooqui","year":"2021","journal-title":"Sci Rep"},{"key":"B73","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s11892-016-0751-5","article-title":"Insulin resistance of puberty","volume":"16","author":"Kelsey","year":"2016","journal-title":"Curr Diabetes Rep"},{"key":"B74","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1530\/acta.0.xxxiv0496","article-title":"Plasma level of growth hormone and chromosome complement in four patients with gonadal dysgenesis (Turner's syndrome)","volume":"34","author":"Fraccaro","year":"1960","journal-title":"Acta Endocrinol"},{"key":"B75","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/j.1365-2362.1976.tb00494.x","article-title":"Diabetes mellitus in gonadal dysgenesis: Studies of insulin and growth hormone secretion","volume":"6","author":"Rasio","year":"1976","journal-title":"Eur J Clin Invest"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1136\/adc.43.231.595","article-title":"Growth hormone secretion in subjects with ovarian dysgenesis and turner's syndrome","volume":"43","author":"Meadow","year":"1968","journal-title":"Arch Dis Childhood"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-196503000-00002","article-title":"Cytogenetic and clinical findings in 48 patients with congenitally defective or absent ovaries","volume":"44","author":"Engel","year":"1965","journal-title":"Med (Baltimore)"},{"key":"B78","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1001\/archinte.1968.00300060071015","article-title":"Hashimoto's thyroiditis and turner's syndrome","volume":"122","author":"Hamilton","year":"1968","journal-title":"Arch Internal Med"},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-313x.1996.tb00117.x","article-title":"Hla dq and dp in Finnish families with celiac disease","volume":"23","author":"Polvi","year":"1996","journal-title":"Eur J Immunogenet"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1080\/08035259950168397","article-title":"Prevalence of coeliac disease in turner syndrome","volume":"88","author":"Ivarsson","year":"1999","journal-title":"Acta Paediatrica (Oslo Norway 1992)"},{"key":"B81","doi-asserted-by":"publisher","first-page":"69","DOI":"10.3109\/08916938909034361","article-title":"Autoimmunity, hla, gm and km polymorphisms in turner's syndrome","volume":"4","author":"Larizza","year":"1989","journal-title":"Autoimmunity"},{"key":"B82","article-title":"Hla frequencies, diabetes mellitus and autoimmunity in turner's patients and their relatives","volume":"21","author":"Cassidy","year":"1978","journal-title":"Annales Genetique"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a007732","article-title":"Genetics of type 1 diabetes","volume":"2","author":"Noble","year":"2012","journal-title":"Cold Spring Harb Perspect Med"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1155\/1993\/243295","article-title":"Increased frequency of hla B17 antigen in girls with turner syndrome and their fathers","volume":"11","author":"Dacou-Voutetakis","year":"1993","journal-title":"Dis Markers"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1306330","article-title":"Diabetes mellitus in children and adolescents with genetic syndromes","volume":"120","author":"Schmidt","year":"2012","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1510657","article-title":"Epidemiological, endocrine and metabolic features in turner syndrome","volume":"151","author":"Gravholt","year":"2004","journal-title":"Eur J Endocrinol"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1002\/art.27270","article-title":"Autoimmune diseases in women with turner's syndrome","volume":"62","author":"Jorgensen","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2012.01.015","article-title":"Autoimmune disorders in women with turner syndrome and women with karyotypically normal primary ovarian insufficiency","volume":"38","author":"Bakalov","year":"2012","journal-title":"J Autoimmun"},{"key":"B89","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/s0022-3476(82)80227-8","article-title":"Organ-specific autoantibodies in children with common endocrine diseases","volume":"100","author":"Bright","year":"1982","journal-title":"J Pediatr"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1991.tb02118.x","article-title":"Islet cell cytoplasmic antibodies (Ica) in diabetes and disorders of glucose tolerance","volume":"8","author":"Marner","year":"1991","journal-title":"Diabetic Med J Br Diabetic Assoc"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2012-0265","article-title":"Prevalence of multiple forms of autoimmunity in Egyptian patients with turner syndrome: Relation to karyotype","volume":"26","author":"Hamza","year":"2013","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00511","article-title":"Autoimmunity predisposition in girls with turner syndrome","volume":"10","author":"Wegiel","year":"2019","journal-title":"Front Endocrinol"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1007\/bf01955936","article-title":"Reduced secretion of gastric inhibitory polypeptide in turner patients with impaired glucose tolerance","volume":"150","author":"Heinze","year":"1991","journal-title":"Eur J Pediatr"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-11-6","article-title":"Delayed beta-cell response and glucose intolerance in young women with turner syndrome","volume":"11","author":"Hjerrild","year":"2011","journal-title":"BMC Endocrine Disord"},{"key":"B95","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12079","article-title":"An evaluation of early cardiometabolic risk factors in children and adolescents with turner syndrome","volume":"78","author":"O'Gorman","year":"2013","journal-title":"Clin Endocrinol"},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-197903000-00002","article-title":"Turner's syndrome and carbohydrate metabolism. i. impaired insulin secretion after tolbutamide and glucagon stimulation tests: Evidence of insulin deficiency","volume":"277","author":"AvRuskin","year":"1979","journal-title":"Am J Med Sci"},{"key":"B97","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-72-4-832","article-title":"Insulin resistance: An early metabolic defect of turner's syndrome","volume":"72","author":"Caprio","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"B98","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1159\/000090907","article-title":"Insulin resistance is an intrinsic defect independent of fat mass in women with turner's syndrome","volume":"65","author":"Salgin","year":"2006","journal-title":"Hormone Res"},{"key":"B99","article-title":"Characteristics of insulin resistance in turner syndrome","volume":"16","author":"Stoppoloni","year":"1990","journal-title":"Diabete Metab"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1098-4","article-title":"The relationship of periaortic fat thickness and cardiovascular risk factors in children with turner syndrome","volume":"36","author":"Aky\u00fcrek","year":"2015","journal-title":"Pediatr Cardiol"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.00482","article-title":"Insulin sensitivity and pancreatic B-cell function in Ecuadorian women with turner syndrome","volume":"11","author":"\u00c1lvarez-Nava","year":"2020","journal-title":"Front Endocrinol"},{"key":"B102","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1172\/jci60016","article-title":"Glucagonocentric restructuring of diabetes: A pathophysiologic and therapeutic makeover","volume":"122","author":"Unger","year":"2012","journal-title":"J Clin Invest"},{"key":"B103","article-title":"Endocrine, cytogenetic and psychometric features of patients with X-isochromosome 46, X, I(Xq) turner's syndrome: A preliminary study in nine patients","volume":"7","author":"Zinman","year":"1984","journal-title":"Clin Invest Med Med Clin Experimentale"},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(15)00482-9","article-title":"The incretin effect in healthy individuals and those with type 2 diabetes: Physiology, pathophysiology, and response to therapeutic interventions","volume":"4","author":"Nauck","year":"2016","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13544","article-title":"Exenatide corrects postprandial hyperglycaemia in young people with cystic fibrosis and impaired glucose tolerance: A randomized crossover trial","volume":"21","author":"Geyer","year":"2019","journal-title":"Diabetes Obes Metab"},{"key":"B106","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.2337\/dc21-S002","article-title":"2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2021","volume":"44","year":"2021","journal-title":"Diabetes Care"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0346","article-title":"Standardized multidisciplinary evaluation yields significant previously undiagnosed morbidity in adult women with turner syndrome","volume":"96","author":"Freriks","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14166","article-title":"A value-based healthcare approach: Health-related quality of life and psychosocial functioning in women with turner syndrome","volume":"92","author":"van den Hoven","year":"2020","journal-title":"Clin Endocrinol"},{"key":"B109","doi-asserted-by":"publisher","first-page":"S98","DOI":"10.2337\/dc20-S009","article-title":"9. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes-2020","volume":"43","year":"2020","journal-title":"Diabetes Care"},{"key":"B110","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1002\/ajmg.c.31676","article-title":"Research priorities of people living with turner syndrome","volume":"181","author":"Sandberg","year":"2019","journal-title":"Am J Med Genet C Semin Med Genet"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1116889\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T05:59:45Z","timestamp":1676440785000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2023.1116889\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,15]]},"references-count":110,"alternative-id":["10.3389\/fendo.2023.1116889"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2023.1116889","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,15]]},"article-number":"1116889"}}