Bone size and density measurements in prepubertal children with Turner syndrome prior to growth hormone therapy.
Using computed tomography (CT), we found the decreases in bone size of vertebrae and femur, cortical bone area (CBA) of femur and bone density (BD) of vertebrae in prepubertal female with Turner syndrome (TS) compared to those of controls.


BACKGROUND
Bone mineral density results from previous studies utilizing single-photon absorptiometry (SPA) or dual-energy X-ray absorptiometry (DXA) in children with TS are controversial. The present study used CT to assess the differences in cancellous and cortical bone size and BD between prepubertal TS patients prior to growth hormone therapy and historical age and ethnicity-matched female controls.


METHODS
Anthropometrics and CT bone measurements including cross-sectional area (CSA) and BD of lumbar vertebrae and femur and CBA of femur in prepubertal TS females were reviewed and compared with those in controls.


RESULTS
Twenty-two prepubertal TS patients had delayed bone age, were shorter and lighter than controls (Ps < 0.001). After adjusting for weight, height and skeletal age, vertebral BD and CBA of the femur were lower in patients than in controls (P < 0.001 and P = 0.021, respectively). However, after additional adjusting for puberty, results were not different from controls. While a positive correlation between vertebral BD and age was noted in controls (r = 0.367, P = 0.092), a significant negative correlation was noted in patients (r = -0.615, P = 0.002).


CONCLUSIONS
While the decrease in vertebrae and femur sizes of patients with TS appeared to be secondary to their small body size, the decreased BD of vertebrae and CBA of femur were likely secondary to estrogen deficiency.
Pitukcheewanont
P
P
Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, University of Southern California, Los Angeles, CA 90027, USA. dpisit@chla.usc.edu
Numbenjapon
N
N
Safani
D
D
Rossmiller
S
S
Gilsanz
V
V
Costin
G
G
D000293:Adolescent; D000365:Age Determination by Skeleton; D000375:Aging / Q000502:physiology; D000886:Anthropometry / Q000379:methods; D049628:Body Size / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D013006:Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011627:Puberty / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014424:Turner Syndrome / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology
D013006:Growth Hormone
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