Bone mineral density in adult patients with Turner's syndrome: analyses of the effectiveness of GH and ovarian steroid hormone replacement therapies.
To analyze the effects of treatments with GH and cyclic estrogen/progesterone (E/P) replacement on bone mineralization in patients with Turner's syndrome (TS), bone mineral density (BMD) was measured longitudinally. BMDs of the whole body and the lumbar spine in 16 adult female patients with TS (17-38 year old; 0-20 years by length of E/P treatment) were assessed using dual energy X-ray absorptiometry one to 5 times over a treatment period of up to 7 years maximum. GH treatment was performed in 9 cases (GH group), but not in the remaining 7 (non-GH group). E/P replacement therapy was initiated in all patients after they finished GH administration. The BMDs of both the whole body and the lumbar spine in the patients with TS were significantly less than those in age-matched normal subjects, and did not improve with E/P treatment. Although there were no differences in final body height and age at the beginning of E/P administration between the GH and non-GH groups, whole body BMD in the GH group was significantly lower than that in the non-GH group. These results indicate that GH administration in childhood and adolescence and E/P treatment in adulthood did not increase bone mineralization in the TS patients. Therefore, we can conclude that the optimal protocol of hormonal replacement therapy with GH and E/P during childhood and adolescence should be established as soon as possible.
Suganuma
Nobuhiko
N
Department of Obstetrics and Gynecology, Branch Hospital, Nagoya University School of Medicine, Nagoya 461-8673, Japan.
Furuhashi
Madoka
M
Hirooka
Takashi
T
Moriwaki
Takayuki
T
Hasegawa
Yukiharu
Y
Mori
Osamu
O
Ogawa
Masamichi
M
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D011374:Progesterone / Q000627:therapeutic use*; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000188:drug therapy* / Q000378:metabolism
D004967:Estrogens; D019382:Human Growth Hormone; D011374:Progesterone