Delay in estrogen commencement is associated with lower bone mineral density in Turner syndrome

Climacteric : the Journal of the International Menopause Society
H H NguyenA Vincent

Abstract

Turner syndrome (TS) is associated with hypogonadism, osteoporosis and fractures. We investigated the prevalence and risk factors for low bone density and fractures in a TS cohort. We included 76 TS patients (median age 28.5 years) attending a tertiary hospital between 1998 and 2015 who underwent dual-energy X-ray absorptiometry. Spine and femoral neck (FN) areal bone mineral density (aBMD) were compared with those of a control group. To adjust for smaller bone size, bone mineral apparent density (BMAD) was calculated. Primary amenorrhea was common (83%) in the TS cohort; the median age of pubertal induction was 15 years (range 11-30 years), and non-continuous estrogen therapy (ET) recorded in 40%. Almost one-third of TS patients reported fractures. TS patients had lower median spinal aBMD (1.026 g/cm(2) vs. 1.221 g/cm(2)) and BMAD (0.156 g/cm(3) vs. 0.161 g/cm(3)) than controls, and lower median FN aBMD (0.850 g/cm(2) vs. 1.026 g/cm(2)) (all p < 0.01). More women with TS had spinal Z-score < -2.0 compared to controls (26.0% vs. 3.6%, p = 0.001). Spine and FN aBMD, BMAD and Z-scores were inversely associated with age commencing ET or years of estrogen deficiency. Delay in ET commencement was an independent risk factor for the l...Continue Reading

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Citations

Aug 11, 2018·Climacteric : the Journal of the International Menopause Society·S ShahA J Vincent
Jul 19, 2018·The Journal of Clinical Endocrinology and Metabolism·Hanh H NguyenAmanda Vincent
Feb 23, 2019·European Journal of Endocrinology·Valérie BernardSophie Christin-Maitre
Sep 2, 2017·Climacteric : the Journal of the International Menopause Society·Gerard S Conway
Jun 20, 2019·Nature Reviews. Endocrinology·Claus H GravholtNiels H Andersen
Sep 25, 2020·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·S SaitoH Sakakibara
Feb 23, 2019·European Journal of Endocrinology·Valérie BernardSophie Christin-Maitre
Nov 28, 2019·Animal Models and Experimental Medicine·Aline Schafrum MacedoCassio Ricardo Auada Ferrigno
Feb 7, 2019·The Journal of Clinical Endocrinology and Metabolism·Antoinette Cameron-PimblettGerard S Conway
Oct 20, 2020·Expert Review of Endocrinology & Metabolism·Mariangela ChiaritoMaria Felicia Faienza
Mar 31, 2021·Seminars in Reproductive Medicine·Navira SamadFrances Milat
May 7, 2021·Climacteric : the Journal of the International Menopause Society·H H NguyenA J Vincent
Sep 4, 2021·Endocrine Reviews·Peter R EbelingFrances Milat

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