Original Paper

Normal Tempo of Bone Formation in Turner Syndrome despite Signs of Accelerated Bone Resorption
Line Cleemann^a, Kirsten Holm^a, Hanne Kobbernagel^b, Sven O. Skouby^c, Bent Kristensen^b, Heidi Smedegaard^a, Anna-Maria Andersson^d, Arieh Cohen^e, Claus H. Gravholt^f

Departments of
^aPediatrics and
^bClinical Physiology, Hillerød Hospital, Hillerød,
^cDepartment of Gynecology and Obstetrics, Herlev University Hospital, Herlev,
^dDepartment of Growth and Reproduction, Copenhagen University Hospital and
^eStatens Serum Institut, Copenhagen, and
^fDepartment of Endocrinology and Internal Medicine and the Medical Research Laboratories, Aarhus Sygehus NBG, Aarhus University Hospital, Aarhus, Denmark

Address of Corresponding Author

Horm Res Paediatr 2011;76:193-201 (DOI: 10.1159/000329046)

  Key Words

• Bone mineral density
• Turner syndrome
• Hormonal replacement therapy
• Dual X-ray absorptiometry
• Growth hormone

  Abstract

Aims: To evaluate area bone mineral density (aBMD) and volumetric BMD (vBMD) by dual-energy X-ray absorptiometry, and relations to bone markers and hormones in adolescent women with Turner syndrome (TS). Methods: Cross-sectional study in TS patients (n = 37, 16.7 ± 3.4 years) and control group (n = 49), assessed by dual-energy X-ray absorptiometry, bone markers and hormones. TS patients were divided into a young group receiving (‘ongoing’) GH (n = 15) and an older group previously receiving (‘previous’) GH (n = 22). Results: vBMD_spine was similar in ‘ongoing GH’ TS, but higher in ‘previous GH’ TS, compared to controls. vBMD_hip was lower in ‘ongoing GH’ TS, but similar in ‘previous GH’. z scores for aBMD were uniformly reduced in ‘ongoing TS’, but near-normalized in ‘previous GH’ TS. Bone formation and resorption markers were increased in ‘ongoing GH’ TS, while ‘previous GH’ TS had elevated bone resorption markers. Conclusion: BMD increased in parallel with age in TS patients receiving optimal estradiol replacement therapy and GH according to consensus guidelines, and in controls. Young TS undergoing pubertal induction and still receiving GH have lower z score BMD than older TS patients receiving hormonal replacement therapy, where a near-normalization of BMD was achieved. TS patients previously receiving GH showed signs of increased bone resorption.

Copyright © 2011 S. Karger AG, Basel

  Author Contacts

Claus Højbjerg Gravholt, MD, PhD
Department of Endocrinology and Internal Medicine
Århus Sygehus NBG
DK–8000 Aarhus C (Denmark)
Tel. +45 8949 2023, E-Mail ch.gravholt@dadlnet.dk

  Article Information

Received: November 5, 2010
Accepted: May 4, 2011
Published online: July 26, 2011
Number of Print Pages : 9
Number of Figures : 2, Number of Tables : 4, Number of References : 39