Clinical significance of the parental origin of the X chromosome in Turner syndrome

Liora Sagi, Nehama Zuckerman-Levin, Aneta Gawlik, Lucia Ghizzoni, Atilla Buyukgebiz, Yardena Rakover, Tzvi Bistritzer, Osnat Admoni, Alessandra Vottero, Oshrat Baruch, Fuad Fares, Ewa Malecka-Tendera, Ze'ev Hochberg

Research output: Contribution to journalArticlepeer-review


Context: The phenotype in Turner syndrome (TS) is variable, even in patients with a supposedly nonmosaic karyotype. Previous work suggested that there were X-linked parent-of-origin effects on the phenotype. Hypothesis: The TS phenotype is influenced by the parental origin of the missed X chromosome. Design: This was a multicenter prospective study of TS patients and both their parents, determining parental origin of the X-chromosome, and characterizing the clinical phenotype. Patients and Methods: Eighty-three TS patients and their parents were studied. Inclusion criteria were TS with karyotype 45,X or 46Xi(Xq). Four highly polymorphic microsatellite markers on the X-chromosome DMD49, DYSII, DXS1283, and the androgen receptor gene and three Y chromosome markers, SRY, DYZ1, and DYZ3. Outcome Measures: The study determined the correlation between the parental origin of the X chromosome and the unique phenotypic traits of TS including congenital malformations, anthropometry and growth pattern, skeletal defects, endocrine traits, education, and vocation. Results: Eighty-three percent of 45,X retained their maternal X (Xm), whereas 64% 46Xi(Xq) retained their paternal X (Xp, P < 0.001). Kidney malformations were exclusively found in Xm patients (P = 0.030). The Xm group had lower total and low-density lipoprotein cholesterol (P < 0.003), and higher body mass index SD score (P = 0.030) that was not maintained after GH treatment. Response to GH therapy was comparable. Ocular abnormalities were more common in the paternal X group (P = 0.017), who also had higher academic achievement. Conclusions: The parental origin of the missing short arm of the X chromosome has an impact on overweight, kidney, eye, and lipids, which suggests a potential effect of an as-yet-undetermined X chromosome gene imprinting.

Original languageEnglish
Pages (from-to)846-852
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
StatePublished - Mar 2007
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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