Effect of Hormone Replacement Therapy on Bone Mineral Density and Body Composition in Chinese Adolescent and Young Adult Turner Syndrome Patients

Li, Li; Qiu, Xiu; Lash, Gendie E.; Yuan, Lei; Liang, Zichao; Liu, Li

doi:10.3389/fendo.2019.00377

Cited by 7 publications

(4 citation statements)

References 28 publications

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“…Current studies have found that decreased HL and BMD increase the risk of fracture in women with TS ( 54 , 55 ), while no study has confirmed that decreased BMD in women with TS increases the risk of HL. Previous studies have found that HRT can effectively improve the BMD levels of the whole body, femoral neck and hip in TS patients ( 56 ). In this study, it was found that after HRT in TS patients, there was no statistical difference in BMD between the normal hearing group and the hearing loss group, suggesting that HRT can improve BMD of patients to a certain extent, but there was no significant improvement in hearing level of patients.…”

Section: Discussionmentioning

confidence: 96%

Incidence and risk factors of hearing loss in patients with Turner Syndrome

Lin

Wang²,

Qin³

et al. 2023

Front. Public Health

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BackgroundHearing loss (HL) is one of the main medical complications for Turner Syndrome (TS) patients, with an earlier presentation and higher incidence than normal women. However, the etiology of HL in TS is unclear. The aim of this study was to investigate the hearing status of TS patients in China and the influencing factors, so as to provide a theoretical basis for early intervention treatment for TS patients with HL.MethodsIn total 46 female patients aged 14–32 diagnosed with TS received tympanic membrane and audiological examinations, including pure tone audiometry and tympanometry. In addition, the effects of karyotype, sex hormone levels, thyroid function, insulin, blood lipids, bone mineral density, age and other factors on hearing levels were analyzed, and the possible risk factors associated with HL in TS patients were explored.ResultsIn 9 patients (19.6%) had HL, including 1 (2.2%) with mild conductive hearing loss, 5 (10.9%) with mild sensorineural hearing loss, 3 (6.5%) with moderate sensorineural hearing loss. TS is often associated with age-related mid-frequency and high-frequency HL, and the incidence of HL increases with age. Compared with other karyotypes, patients with 45, X haplotype have an increased risk of mid-frequency HL.ConclusionsTherefore, karyotype may be a predictor of hearing problems in TS.

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Section: Discussionmentioning

confidence: 96%

Incidence and risk factors of hearing loss in patients with Turner Syndrome

Lin

Wang²,

Qin³

et al. 2023

Front. Public Health

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“…The study's authors emphasized the need for long-term investigations to determine whether this effect persists after discontinuing rhGH therapy. Abdominal obesity, strongly linked to insulin resistance and MetS features, is notably prevalent in adult women with TS, with greater fat mass assessed through dual-energy X-ray absorptiometry (DXA) or magnetic resonance imaging (MRI) [38,39]. In contrast, adolescents with TS did not show significant differences in total body weight and VF compared to the control group [13].…”

Section: Discussionmentioning

confidence: 99%

Are Young People with Turner Syndrome Who Have Undergone Treatment with Growth and Sex Hormones at Higher Risk of Metabolic Syndrome and Its Complications?

Krzyścin,

Sowińska-Przepiera,

Gruca-Stryjak

et al. 2024

Biomedicines

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Introduction: Metabolic syndrome (MetS), characterized by visceral obesity, glucose abnormalities, hypertension and dyslipidemia, poses a significant risk of diabetes and cardiovascular disease. Turner syndrome (TS), resulting from X chromosome abnormalities, carries health complications. Despite growing evidence of an increased risk of MetS in women with TS, its prevalence and risk factors remain under investigation. These considerations are further complicated by the varying timing and dosages of treatment with growth hormone and sex hormones. Methods: We conducted a cross-sectional study comparing 44 individuals with TS with 52 age-matched control subjects. Growth hormone treatment in the study group was administered for varying lengths of time, depending on clinical response. We collected anthropometric, metabolic, endocrine and body composition data. Statistical analyses included logistic regression. Results: Baseline characteristics, including age, BMI and height, were comparable between the TS and control groups. Hormonally, individuals with TS showed lower levels of testosterone, DHEA-S, and cortisol, as well as elevated FSH. Lipid profiles indicated an atherogenic profile, and the body composition analysis showed increased visceral adipose tissue in those with TS. Other metabolic abnormalities were common in individuals with TS too, including hypertension and impaired fasting glucose levels. The risk of MetS components was assessed in subgroups according to karyotypes: monosomy 45X0 vs. other mosaic karyotypes. Logistic regression analysis showed a significant association between increased visceral adipose tissue in subjects with TS. Those with metabolic complications tended to have less muscle strength compared to those without these complications in both the study and control groups. Conclusions: This study highlights the unique metabolic and cardiovascular risk profile of individuals with TS, characterized by atherogenic lipids, higher levels of visceral adipose tissue and increased metabolic abnormalities. These findings underscore the importance of monitoring metabolic health in individuals with TS, regardless of age, BMI or karyotype, and suggest the potential benefits of lifestyle modification, building more muscle strength, and weight control strategies. Further research is needed to better understand and address the metabolic challenges faced by women with TS.

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“…However, the limitations of this method should be taken into account. One of the disadvantages is the influence of body size on areal BMD interpretation, which is important in the case of TS patients [ 14 ]. Therefore, one of the studies selected for our meta-analysis estimated another parameter—bone mineral apparent density (BMAD).…”

Section: Methodsmentioning

confidence: 99%

Effect of Growth Hormone and Estrogen Replacement Therapy on Bone Mineral Density in Women with Turner Syndrome: A Meta-Analysis and Systematic Review

Szybiak,

Kujawa,

Miedziaszczyk

et al. 2023

Pharmaceuticals

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Osteoporosis is a serious implication of Turner syndrome (TS). Common methods for the treatment of TS are growth hormone (GHT) and estrogen replacement therapy (ERT). We examined the relationship between the treatment of TS and bone mineral density (BMD) of the lumbar spine. The purpose of our study was to show the currency of BMD states among patients with TS for treatment with GHT and ERT. We searched databases for studies published from inception to April 2023. The articles were related to TS, osteoporosis, ERT, GHT, BMD and treatment patients with TS. We applied the selection criteria: lumbar spine values at L1–L4; dual-energy X-ray absorptiometry (DXA); treatment which was applied: one group of articles: ERT and two group of articles: GHT; results performed as means ± SD. In total, 79 articles were analyzed, of which 20 studies were included and 5 were considered for meta-analysis. The total number of women in the articles selected was 71. Based on the results of the meta-analysis, the effect of ERT on BMD demonstrated a significant increase in BMD (the standardized mean difference in the random model was 0.593 g/cm2, 95% CI: 0.0705 to 1.116; p = 0.026), which showed that treatment with estrogen particularly increases bone mass during treatment, which contributes to reducing the risk of fractures. The effect of GHT on BMD demonstrated a non-significant decrease in BMD in patients with TS. The results for growth hormone show that this therapy does not improve bone density. However, our review emphasizes the beneficial effect of supplementing growth hormone (GH) on the clinical presentation of TS.

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Effect of Hormone Replacement Therapy on Bone Mineral Density and Body Composition in Chinese Adolescent and Young Adult Turner Syndrome Patients

Cited by 7 publications

References 28 publications

Incidence and risk factors of hearing loss in patients with Turner Syndrome

Incidence and risk factors of hearing loss in patients with Turner Syndrome

Are Young People with Turner Syndrome Who Have Undergone Treatment with Growth and Sex Hormones at Higher Risk of Metabolic Syndrome and Its Complications?

Effect of Growth Hormone and Estrogen Replacement Therapy on Bone Mineral Density in Women with Turner Syndrome: A Meta-Analysis and Systematic Review

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