Turner SyndromeNCT05346159
Effects of Adrenal Androgens on Gender-typed Behavior in Girls With Turner Syndrome
An observational study of Turner Syndrome, run by Sohag University at 1 site in Egypt.
Trial summary
Turner syndrome (TS) is a genetic disorder in which there is loss of all or part of the second X chromosome and occurs in 1/2500 live female births. TS is characterized by short stature and endocrine abnormalities, such as the loss of ovarian function (Gonadal dysgenesis) and estrogen deficiency. Read more about this study
- Who is it for?
- Ages Up to 18 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Turner Syndrome
- What is being tested?
- the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS
- How many people
- 78 participants
- Where
- 1 siteEgypt
- Study dates
- 1 May 2022to 31 May 2023
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 18 years
- Women only
- Healthy volunteers accepted
- Child, Adult
Study population: Girls with turner syndrome (TS) (karyotype 45, X) younger than 18 years of age and Tanner stage matched healthy control girls with normal karyotype attending outpatient clinic at Sohag University Hospital will be included in the study
Who may be able to join
- Girls with turner syndrome (TS) (karyotype 45, X) younger than 18 years of age and Tanner stage matched healthy control girls with normal karyotype attending outpatient clinic at Sohag University Hospital will be included in the study.
Who cannot join
- failure to obtain informed consent
Trial locations and contacts
1 site in 1 country.
About this study
Turner syndrome (TS) is a genetic disorder in which there is loss of all or part of the second X chromosome and occurs in 1/2500 live female births. TS is characterized by short stature and endocrine abnormalities, such as the loss of ovarian function (Gonadal dysgenesis) and estrogen deficiency.
The absence of pubertal development is one of the most common clinical features of patients with TS, who should have experienced a sex hormone surge if the hypothalamic-pituitary-gonadal axis was activated normally . Gonadarche and adrenarche are regarded as processes that are independent of each other. The function of adrenal gland is independent of true (central/complete/gonadotropin- dependent) puberty . Adrenal androgen in Turner syndrome shows a wide spectrum, ranging from normal to highly elevated.
Read more
X-linked genes affect the brain in at least two ways: by directly acting on the brain and by indirectly acting on the gonads to induce differences in specific gonadal secretions (i.e., hormones) that have specific effects on brain development. The changes in brain and behavioral/ cognitive phenotypes in TS individuals may be the result of a direct genetic factor, an indirect hormonal factor, or a combination of the two factors .
To evaluate direct effect of X chromosome, a lot of neuroimaging studies have revealed both neuroanatomical and neurofunctional changes in patients with TS. S. C. Mueller (2013) reported that oestrogen deficiency exhibits paradoxical healthy male-like patterns (i.e., a larger amygdala but reduced hippocampal volume). This finding confirms the indirect hormonal effect on the brain that are likely attributed to the effect of androgen on the brain or may be due to active role of estrogen in feminization of brain .
The cognitive phenotypes of TS include severe deficits in multiple cognitive domains: visual-spatial ability, mathematical processing, and social cognition. Regarding intelligence, numerous TS studies have a lower performance IQ in contrast to a within-normal verbal IQ in TS individuals .
The presence of hypogonadism with normal or may be elevated adrenal function in girls with turner syndrome provide a model to study the hormonal effect of adrenal androgen in absence of estrogen on gender-role behavior. Ehrhardt et al (1970) reported that Women with TS are described as clearly feminine in their behavior and interests .
To the best of our knowledge, there have been no previous studies on the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS.
- Conditions
- Turner Syndrome
- Being tested
- the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS
- Medical subject headings
- Turner Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
the correlation between level of adrenal androgen and gender-typed behavior in Girls with TSDiagnostic test
Laboratory assessment Serum dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) will be measured using an enzyme mediated chemiluminescence for all participants Gender-typed behavior assessment
- Parents of girls aged two to six years will evaluate their children's gender-typed behavior using the Pre school Activities Inventory
- For girls above 6 years gender characteristics and gender role behavior will be evaluated using The Children's Sex Role Inventory (Child-adapted version of the original Bem Sex Role Inventory)
- For all participants a Parent-Report Gender Identity Questionnaire for Children will be used to evaluate gender role behavior
| Study group | Role | What they receive |
|---|---|---|
| turner syndrome group | Not described Receives: Diagnostic Test: the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS | |
| control group | Not described Receives: Diagnostic Test: the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS |
What is being measured
The primary outcome is the main question the study is designed to answer.
Serum dehydroepiandrosterone sulfate (DHEAS)
we use DHEAS level to access adrenal function
Measured: Baseline
follicle stimulating hormone (FSH)
to access ovarian function
Measured: Baseline
luteinizing hormone (LH)
to access ovarian function
Measured: Baseline
estradiol (E2)
to access ovarian function
Measured: Baseline
Gender-typed behavior
we will measure children's gender-typed behavior using the Pre school Activities Inventory
Measured: Baseline
Gender-typed behavior The Children's Sex Role Inventory
we will measure children's gender-typed behavior using The Children's Sex Role Inventory
Measured: Baseline
Parent-Report Gender Identity Questionnaire
we will measure children's gender-typed behavior using the Parent-Report Gender Identity Questionnaire
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Apr 2022
- Study start1 May 2022
- Primary completion31 May 2023
- Study completion31 May 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Turner SyndromeStudies of the same condition, open and under way.
- More trials run by Sohag UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Enrolment
- 78 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sohag University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Menatalla Moamen Ramadan Mohamed, Sohag University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05346159
- Sponsor's protocol ID
- soh-med-22-04-09
- Status last verified
- Jun 2023
- First submitted
- 17 Apr 2022
- Last updated
- 15 Jun 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Li M, Zhao C, Xie S, Liu X, Zhao Q, Zhang Z, Gong G. Effects of hypogonadism on brain development during adolescence in girls with Turner syndrome. Hum Brain Mapp. 2019 Dec 1;40(17):4901-4911. doi: 10.1002/hbm.24745. Epub 2019 Aug 7.
PubMed 31389646Counts DR, Pescovitz OH, Barnes KM, Hench KD, Chrousos GP, Sherins RJ, Comite F, Loriaux DL, Cutler GB Jr. Dissociation of adrenarche and gonadarche in precocious puberty and in isolated hypogonadotropic hypogonadism. J Clin Endocrinol Metab. 1987 Jun;64(6):1174-8. doi: 10.1210/jcem-64-6-1174.
PubMed 3571422Zhao C, Gong G. Mapping the effect of the X chromosome on the human brain: Neuroimaging evidence from Turner syndrome. Neurosci Biobehav Rev. 2017 Sep;80:263-275. doi: 10.1016/j.neubiorev.2017.05.023. Epub 2017 Jun 4.
PubMed 28591595Ehrhardt AA, Greenberg N, Money J. Female gender identity and absence of fetal gonadal hormones: Turner's syndrome. Johns Hopkins Med J. 1970 May;126(5):237-48. No abstract available.
PubMed 4911705Mueller SC. Magnetic resonance imaging in paediatric psychoneuroendocrinology: a new frontier for understanding the impact of hormones on emotion and cognition. J Neuroendocrinol. 2013 Aug;25(8):762-70. doi: 10.1111/jne.12048.
PubMed 23656557Johnson LL, Bradley SJ, Birkenfeld-Adams AS, Kuksis MA, Maing DM, Mitchell JN, Zucker KJ. A parent-report gender identity questionnaire for children. Arch Sex Behav. 2004 Apr;33(2):105-16. doi: 10.1023/b:aseb.0000014325.68094.f3.
PubMed 15146143Dorr HG, Penger T, Marx M, Rauh M, Oppelt PG, Volkl TKM. Adrenarche and pubarche in girls with turner syndrome during growth-promoting therapy with human growth hormone. BMC Endocr Disord. 2019 Jan 18;19(1):9. doi: 10.1186/s12902-019-0333-z.
PubMed 30658614
Study at a glance
From the registry record, last updated by the sponsor on 15 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Adrenal Androgens on Gender-typed Behavior in Girls With Turner Syndrome
- ClinicalTrials.gov ID
- NCT05346159
- Acronym / sponsor ID
- soh-med-22-04-09
- Conditions
- Turner Syndrome
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 78 participants (actual)
- Lead sponsor
- Sohag UniversityUniversity, hospital or other
- Study start
- 1 May 2022 (actual)
- Primary completion
- 31 May 2023 (actual)
- Study completion
- 31 May 2023 (actual)
- First posted
- 26 Apr 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Turner syndrome (TS) is a genetic disorder in which there is loss of all or part of the second X chromosome and occurs in 1/2500 live female births. TS is characterized by short stature and endocrine abnormalities, such as the loss of ovarian function (Gonadal dysgenesis) and estrogen deficiency.
The absence of pubertal development is one of the most common clinical features of patients with TS, who should have experienced a sex hormone surge if the hypothalamic-pituitary-gonadal axis was activated normally . Gonadarche and adrenarche are regarded as processes that are independent of each other. The function of adrenal gland is independent of true (central/complete/gonadotropin- dependent) puberty . Adrenal androgen in Turner syndrome shows a wide spectrum, ranging from normal to highly elevated.
X-linked genes affect the brain in at least two ways: by directly acting on the brain and by indirectly acting on the gonads to induce differences in specific gonadal secretions (i.e., hormones) that have specific effects on brain development. The changes in brain and behavioral/ cognitive phenotypes in TS individuals may be the result of a direct genetic factor, an indirect hormonal factor, or a combination of the two factors .
To evaluate direct effect of X chromosome, a lot of neuroimaging studies have revealed both neuroanatomical and neurofunctional changes in patients with TS. S. C. Mueller (2013) reported that oestrogen deficiency exhibits paradoxical healthy male-like patterns (i.e., a larger amygdala but reduced hippocampal volume). This finding confirms the indirect hormonal effect on the brain that are likely attributed to the effect of androgen on the brain or may be due to active role of estrogen in feminization of brain .
The cognitive phenotypes of TS include severe deficits in multiple cognitive domains: visual-spatial ability, mathematical processing, and social cognition. Regarding intelligence, numerous TS studies have a lower performance IQ in contrast to a within-normal verbal IQ in TS individuals .
The presence of hypogonadism with normal or may be elevated adrenal function in girls with turner syndrome provide a model to study the hormonal effect of adrenal androgen in absence of estrogen on gender-role behavior. Ehrhardt et al (1970) reported that Women with TS are described as clearly feminine in their behavior and interests .
To the best of our knowledge, there have been no previous studies on the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS.
Study design
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| turner syndrome group | – | Diagnostic Test: the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS |
| control group | – | Diagnostic Test: the correlation between level of adrenal androgen and gender-typed behavior in Girls with TS |
Who may qualify
- Ages
- Up to 18 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
- Study population
- Girls with turner syndrome (TS) (karyotype 45, X) younger than 18 years of age and Tanner stage matched healthy control girls with normal karyotype attending outpatient clinic at Sohag University Hospital will be included in the study
Key inclusion criteria (1 listed)
- Girls with turner syndrome (TS) (karyotype 45, X) younger than 18 years of age and Tanner stage matched healthy control girls with normal karyotype attending outpatient clinic at Sohag University Hospital will be included in the study.
Key exclusion criteria (1 listed)
- failure to obtain informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| the correlation between level of adrenal androgen and gender-typed behavior in Girls with TSLaboratory assessment Serum dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) will be measured using an enzyme mediated chemiluminescence for all participants Gender-typed behavior assessment * Parents of girls aged two to six years will evaluate their children's gender-typed behavior using the Pre school Activities Inventory * For girls above 6 years gender characteristics and gender role behavior will be evaluated using The Children's Sex Role Inventory (Child-adapted version of the original Bem Sex Role Inventory) * For all participants a Parent-Report Gender Identity Questionnaire for Children will be used to evaluate gender role behavior | Diagnostic test | control group, turner syndrome group |
Primary outcome
Serum dehydroepiandrosterone sulfate (DHEAS)
Time frame: Baseline
we use DHEAS level to access adrenal function
follicle stimulating hormone (FSH)
Time frame: Baseline
to access ovarian function
luteinizing hormone (LH)
Time frame: Baseline
to access ovarian function
estradiol (E2)
Time frame: Baseline
to access ovarian function
Gender-typed behavior
Time frame: Baseline
we will measure children's gender-typed behavior using the Pre school Activities Inventory
Gender-typed behavior The Children's Sex Role Inventory
Time frame: Baseline
we will measure children's gender-typed behavior using The Children's Sex Role Inventory
Parent-Report Gender Identity Questionnaire
Time frame: Baseline
we will measure children's gender-typed behavior using the Parent-Report Gender Identity Questionnaire
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jun 2023.
- Background: PubMed 31389646Li M, Zhao C, Xie S, Liu X, Zhao Q, Zhang Z, Gong G. Effects of hypogonadism on brain development during adolescence in girls with Turner syndrome. Hum Brain Mapp. 2019 Dec 1;40(17):4901-4911. doi: 10.1002/hbm.24745. Epub 2019 Aug 7.
- Background: PubMed 3571422Counts DR, Pescovitz OH, Barnes KM, Hench KD, Chrousos GP, Sherins RJ, Comite F, Loriaux DL, Cutler GB Jr. Dissociation of adrenarche and gonadarche in precocious puberty and in isolated hypogonadotropic hypogonadism. J Clin Endocrinol Metab. 1987 Jun;64(6):1174-8. doi: 10.1210/jcem-64-6-1174.
- Background: PubMed 28591595Zhao C, Gong G. Mapping the effect of the X chromosome on the human brain: Neuroimaging evidence from Turner syndrome. Neurosci Biobehav Rev. 2017 Sep;80:263-275. doi: 10.1016/j.neubiorev.2017.05.023. Epub 2017 Jun 4.
- Background: PubMed 4911705Ehrhardt AA, Greenberg N, Money J. Female gender identity and absence of fetal gonadal hormones: Turner's syndrome. Johns Hopkins Med J. 1970 May;126(5):237-48. No abstract available.
- Background: PubMed 23656557Mueller SC. Magnetic resonance imaging in paediatric psychoneuroendocrinology: a new frontier for understanding the impact of hormones on emotion and cognition. J Neuroendocrinol. 2013 Aug;25(8):762-70. doi: 10.1111/jne.12048.
- Background: PubMed 15146143Johnson LL, Bradley SJ, Birkenfeld-Adams AS, Kuksis MA, Maing DM, Mitchell JN, Zucker KJ. A parent-report gender identity questionnaire for children. Arch Sex Behav. 2004 Apr;33(2):105-16. doi: 10.1023/b:aseb.0000014325.68094.f3.
- Background: PubMed 30658614Dorr HG, Penger T, Marx M, Rauh M, Oppelt PG, Volkl TKM. Adrenarche and pubarche in girls with turner syndrome during growth-promoting therapy with human growth hormone. BMC Endocr Disord. 2019 Jan 18;19(1):9. doi: 10.1186/s12902-019-0333-z.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Turner Syndrome, run by Sohag University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Serum dehydroepiandrosterone sulfate (DHEAS) (time frame: Baseline). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05346159, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2023.