Long-term hormone replacement therapy preserves bone mineral density in Turner syndrome.

Abstract

CONTEXT:

Reduced bone mineral density (BMD) and increased risk of fractures are present in many women with Turner syndrome (TS).

OBJECTIVE:

Examine longitudinal changes in BMD in TS and relate changes to biochemical parameters.

DESIGN:

Prospective, pragmatic, and observational study. Examinations at baseline and follow-up (5.9+/-0.7 years).

SETTING:

Tertiary hospital.

PARTICIPANTS:

Fifty-four women with TS (43.0+/-9.95 years). Interventions Hormone replacement therapy (HRT) and calcium and vitamin D supplementation. Main outcome measures BMD (g/cm(2)) measured at lumbar spine, hip, and the non-dominant forearm. Bone formation and resorption markers, sex hormones, IGF1, and maximal oxygen uptake.

RESULTS:

At follow-up, forearm BMD, radius ultradistal BMD, and hip BMD remained unchanged, radius 1/3 BMD declined (0.601+/-0.059 vs 0.592+/-0.059, P=0.03), while spine BMD increased (0.972+/-0.139 vs 1.010+/-0.144, P<0.0005). Bone formation markers did not change over time in TS. Bone resorption markers decreased over time in TS. Testosterone, IGF1, and maximal oxygen uptake was significantly reduced in TS.

CONCLUSION:

Longitudinal changes in BMD in TS were slight. BMD can be maintained at most sites in well-informed women with TS, being encouraged to maintain a healthy lifestyle, including HRT and intake of calcium and vitamin D.

• Authors: Line Cleemann, Britta E Hjerrild, Anna L Lauridsen, Lene Heickendorff, Jens S Christiansen, Leif Mosekilde, Claus H Gravholt
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 161 Issue 2 Pg. 251-7 (Aug 2009) ISSN: 1479-683X [Electronic] England
• PMID: 19447901 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Estrogens
• Vitamin D
• Calcium

Topics

• Absorptiometry, Photon
• Adult
• Aged
• Bone Density (drug effects)
• Bone and Bones (drug effects, metabolism)
• Calcium (administration & dosage)
• Estrogen Replacement Therapy (methods)
• Estrogens (administration & dosage)
• Exercise
• Female
• Heart Rate (physiology)
• Humans
• Longitudinal Studies
• Middle Aged
• Prospective Studies
• Turner Syndrome (drug therapy, metabolism)
• Vitamin D (administration & dosage)
• Young Adult