HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: EJE-09-0020v1 EJE-09-0020v2 161/2/251    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cleemann, L. Articles by Gravholt, C. H Search for Related Content PubMed PubMed Citation Articles by Cleemann, L. Articles by Gravholt, C. H

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

Pediatric Unit, Nordsjællands Hospital Hillerød, DK-3400 Hillerød, Denmark¹ Medical Department M (Endocrinology and Diabetes) and the Medical Research Laboratories, Aarhus Sygehus NBG² Department of Clinical Biochemistry, Aarhus Sygehus³ Department of Endocrinology and Metabolism, Aarhus Sygehus THG, Aarhus University Hospital, DK-8000 Aarhus C, Denmark

(Correspondence should be addressed to C H Gravholt; Email: ch.gravholt{at}dadlnet.dk)

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/cm²) 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.