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Insulin resistance and metabolic syndrome in prepubertal boys with Klinefelter syndrome


Judith L Ross, M.D., Division of Endocrinology, Department of Pediatrics, Thomas Jefferson University, 1025 Walnut Street, Suite 726, Philadelphia, PA 19107, USA.
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Aims:  To investigate risk factors for metabolic syndrome in prepubertal boys with Klinefelter syndrome.

Methods:  Eighty-nine boys with Klinefelter syndrome, ages 4–12.9 years, and 34 age-matched control boys had height, weight, waist circumference and blood pressure measured and their parents completed a questionnaire about physical activity. The boys with Klinefelter syndrome also had measurement of lipids, fasting glucose and insulin. Insulin-glucose homeostasis model assessment was calculated, and the boys were evaluated for childhood metabolic syndrome.

Results:  The Klinefelter syndrome and control groups were similar ages (7.5 ± 2.4 vs. 8.1 ± 2.3 years). Body mass index measurements were similar, but waist circumference was >90 percentile in 30% of boys with Klinefelter syndrome versus 21% of controls. The mean daily time spent running was 42 min less in the Klinefelter syndrome versus control groups (p < 0.01). About 37% of the boys with Klinefelter syndrome had elevated LDL cholesterol, 24% had insulin resistance, and 7% met the three criteria for diagnosis of metabolic syndrome.

Conclusions:  Truncal obesity, insulin resistance and metabolic syndrome are present in boys as young as 4–12 years with Klinefelter syndrome, and these occur in association with reduced running-type activity.