title: Dosage of estradiol, bone and body composition in Turner syndrome: a 5-year randomized controlled clinical trial.
abstract: OBJECTIVE
  Reduced bone mineral density (BMD) is seen in Turner syndrome (TS) with an increased risk of fractures, and body composition is characterized by increased body fat and decreased lean body mass. To evaluate the effect of two different doses of oral 17B-estradiol in young TS women on bone mineral density (BMD), biochemical markers of bone turnover and body composition with the hypothesis of a positive effect of the higher dose.
  
  
  METHODS
  A double-blind 5-year randomized controlled clinical trial. 20 young TS women participated. Inclusion criteria were diagnosis of TS, age 15-25 years and current treatment with 2 mg oral estradiol daily.
  
  
  METHODS
  The low-dose (LD) group was administered 2 mg 17B-estradiol/day orally and placebo, the high-dose (HD) group was administered 2 + 2 mg 17B-estradiol/day orally. Main outcome measures were whole body and regional bone mineral density (BMD), lean body mass (LBM), fat mass (FM) measured yearly by DXA scan and resorptive and formative bone markers in serum.
  
  
  RESULTS
  BMD, whole body and regional, increased over time with an attenuation toward the end of the study, and bone turnover markers decreased over time, both with no differences between the treatment groups (P = 0.2-0.9). LBM increased significantly more in the HD group (P = 0.02). FM remained stable in both groups.
  
  
  CONCLUSIONS
  A steady increase in BMD over time in TS was found similar to healthy young women. The higher estrogen dose did not differentially affect BMD or bone markers. The positive effect on body composition may have long-ranging health benefits in TS.
authors.affiliation: Department of Pediatrics line.cleemann@regionh.dk.
authors.forename: Line
authors.initials: L
authors.lastname: Cleemann
authors.affiliation: Department of Pediatrics.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Holm
authors.affiliation: Department of RadiologyNordsjællands Hospital, Hillerød, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Kobbernagel
authors.affiliation: Department of RadiologyNordsjællands Hospital, Hillerød, Denmark.
authors.forename: Bent
authors.initials: B
authors.lastname: Kristensen
authors.affiliation: Department of Gynecology and ObstetricsHerlev University Hospital, Herlev, Denmark.
authors.forename: Sven Oluf
authors.initials: SO
authors.lastname: Skouby
authors.affiliation: Center of Research and InnovationNordsjællands Hospital, Hillerød, Denmark.|Department of Public HealthUniversity of Copenhagen, Copenhagen, Denmark.
authors.forename: Andreas Kryger
authors.initials: AK
authors.lastname: Jensen
authors.affiliation: Department of Endocrinology and Internal Medicine and the Medical Research LaboratoriesAarhus Sygehus NBG, Aarhus University Hospital, Aarhus C, Denmark.|Department of Molecular MedicineAarhus University Hospital, Aarhus N, Denmark.
authors.forename: Claus H
authors.initials: CH
authors.lastname: Gravholt
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D014424:Turner Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D004958:Estradiol