Bone mineral density in Turner's syndrome—a longitudinal study

Shaw, Nicholas; Rehan, Virender K.; Husain, Syeda Fabeha; Marshall, T.; Smith, C. S.

doi:10.1046/j.1365-2265.1997.2791084.x

Cited by 51 publications

(38 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies showed that GH-and HRT-treated patients had normal lumbar BMD by DXA, suggesting that the axial trabecular bone was preserved in young adults with TS. 9,13,15 On the other hand, skeletal sites with predominantly cortical bone had a reduced BMD measured by DXA, pQCT and QUS. [9][10][11][12]38,39 Recently, Hansen and colleagues, using high-resolution pQCT, observed that adult TS women (mean age 35 years, range 20-61) also had defective trabecular micro-architecture at the distal radius and tibia compared to healthy adults.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12] Conversely, it was observed that TS patients receiving appropriate oestrogen treatment usually showed normal trabecular BMD after adjusting for body size. [13][14][15][16][17] In addition to Hormonal Replacement Therapy (HRT), Growth Hormone (GH) administration is considered standard treatment for TS girls, but the role of GH in promoting bone accrual has not yet been completely defined. [18][19][20] Several studies reported in TS patients an increase in fracture prevalence and risk that was higher during childhood and after the age of 45.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

Vierucci¹,

Pistoia²,

Erba³

et al. 2002

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

Vierucci¹,

Pistoia²,

Erba³

et al. 2002

View full text Add to dashboard Cite

show abstract

“…(7,8) Similarly, when TS patients were compared to individuals with the same age and height, bone mass appeared ample for bone size. (15,16) Thus other aspects of bone characteristics such as bone geometry (17) or cortical and/or trabecular microarchitecture may be altered in TS, possibly compromising skeletal integrity and increasing the risk of fracture.…”

Section: Introductionmentioning

confidence: 99%

Compromised trabecular microarchitecture and lower finite element estimates of radius and tibia bone strength in adults with turner syndrome: A cross-sectional study using high-resolution–pQCT

Hansen

Brixen

Gravholt

2012

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Although bone mass appear ample for bone size in Turner syndrome (TS), epidemiological studies have reported an increased risk of fracture in TS. We used high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure standard morphological parameters of bone geometry and microarchitecture, as well as estimated bone strength by finite element analysis (FEA) to assess bone characteristics beyond bone mineral density (BMD) that possibly contribute to the increased risk of fracture. Thirty-two TS patients (median age 35, range 20-61 years) and 32 healthy control subjects (median age 36, range 19-58 years) matched with the TS participants with respect to age and body-mass index were studied. A full region of interest (ROI) image analysis and a height-matched ROI analysis adjusting for differences in body height between groups were performed. Mean bone cross-sectional area was lower in TS patients in radius (À15%) and tibia (À13%) (both p < 0.01) whereas cortical thickness was higher in TS patients in radius (18%, p < 0.01) but not in tibia compared to controls. Cortical porosity was lower in TS patients at both sites (À32% in radius, À36% in tibia, both p < 0.0001). Trabecular integrity was compromised in TS patients with lower bone volume per tissue volume (BV/TV) (À27% in radius, À22% in tibia, both p < 0.0001), trabecular number (À27% in radius, À12% in tibia, both p < 0.05), and higher trabecular spacing (54% in radius, 23% in tibia, both p < 0.01). In the height-matched ROI analysis, differences remained significant apart from total area at both sites, cortical thickness in radius, and trabecular number in tibia. FEA estimated failure load was lower in TS patients in both radius (À11%) and tibia (À16%) (both p < 0.01) and remained significantly lower in the height-matched ROI analysis. Conclusively, TS patients had compromised trabecular microarchitecture and lower bone strength at both skeletal sites, which may partly account for the increased risk of fracture observed in these patients. ß

show abstract

“…Female patients with Turner’s syndrome usually present with smaller bone and body sizes in comparison with normal women [1]. Because areal BMD (aBMD), usually assessed by current densitometric techniques, is influenced by bone dimensions and height [8, 9, 10], the reduced bone and body sizes might determine an ‘apparent’ low aBMD in these patients [1, 2, 11]. To elucidate this issue, we measured the volumetric BMD (vBMD), which is less dependent on body and bone sizes [9], in young women with Turner’s syndrome on estrogen replacement therapy (ERT) from adolescence.…”

Section: Introductionmentioning

confidence: 99%

Volumetric Bone Mineral Density in Young Women with Turner’s Syndrome Treated with Estrogens or Estrogens plus Growth Hormone

Bertelloni

Cinquanta²,

Baroncelli³

et al. 2000

Horm Res Paediatr

View full text Add to dashboard Cite

To explore the effects of estrogen replacement therapy (ERT) and recombinant growth hormone (GH) treatment on bone mineral density (BMD) in Turner’s syndrome, we assessed volumetric BMD (vBMD), which is less dependent on body and bone sizes, in these patients at final height. The areal BMD (aBMD) was measured in 26 young women with Turner’s syndrome (age range 17.5–25.0 years) by dual-energy X-ray absorptiometry, and vBMD was calculated. Patients were subdivided as group 1 (n = 12; ERT alone) and group 2 (n = 14; GH + ERT). Years of estrogen exposure were not different between the groups (group 1: 6.4 ± 1.5 years; group 2: 5.3 ± 1.7 years); in group 2, GH therapy was 5.3 ± 1.4 years. Final heights were significantly higher in group 2 than in group 1 (148.1 ± 3.0 vs. 142.0 ± 2.8 cm; p < 0.0001) as well as aBMD (1.073 ± 0.118 vs. 0.968 ± 0.122 g/cm²; p < 0.04). vBMD was higher in group 2 but not significantly different from group 1 (0.374 ± 0.030 vs. 0.358 ± 0.027 g/cm³; p = 0.169). aBMD was reduced with respect to the normative values in both groups (group 1: –1.97 ± 1.04 SDS, p < 0.0001 vs. 0; group 2: –0.93 ± 1.01 SDS, p < 0.005 vs. 0), whereas vBMD was not (group 1: –0.07 ± 0.79 SDS; group 2: 0.42 ± 0.82 SDS). Our data suggest that: in Turner’s syndrome GH administration improves final height and aBMD, but it does not significantly increase vBMD; aBMD reduction in Turner’s syndrome is likely due to the impaired growth and reduced bone size; Turner’s patients on ERT from adolescence show vBMD values in the normal range in young adulthood.

show abstract

Bone mineral density in Turner's syndrome—a longitudinal study

Abstract: As there is little evidence of reduced bone mineral density in girls with Turner's syndrome there is no justification for an early introduction of oestrogen replacement during the prepubertal years.

Cited by 51 publications

References 15 publications

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

Compromised trabecular microarchitecture and lower finite element estimates of radius and tibia bone strength in adults with turner syndrome: A cross-sectional study using high-resolution–pQCT

Volumetric Bone Mineral Density in Young Women with Turner’s Syndrome Treated with Estrogens or Estrogens plus Growth Hormone

Contact Info

Product

Resources

About