OSTEOPOROSIS IN TURNERS-SYNDROME AND OTHER FORMS OF PRIMARY AMENORRHEA

OBJECTIVE Osteopenia in Turner's syndrome is well recognized. This stu dy is aimed to elucidate whether this is an intrinsic feature of the d isorder, or is a nonspecific feature resulting from oestrogen deficien cy. DESIGN Comparison of bone mineral density and fracture rate in Tur ner's patients and in 46,XX women with equivalent oestrogen deprivatio n from other causes.SUBJECTS One hundred and twenty women in the repro ductive age range (16-45 years): 40 with Turner's syndrome, 40 with ot her forms of primary amenorrhoea, and 40 healthy controls matched to p atients for duration of oestrogen usage. MEASUREMENTS Measurement of b one mineral density in the lumbar spine (and femoral neck in some subj ects) by dual-energy X-ray absorptiometry, and reported history of fra cture. RESULTS Vertebral bone mineral density was similar in women wit h Turner's syndrome (mean 0.84, SD 0.11 g/cm(2)) and those with other causes of primary amenorrhoea (mean 0.81, SD 0.11 g/cm(2); P = 0.26). Both groups had severe osteopenia compared with healthy controls (mean 1.06, SD 0.09 g/cm(2), P < 0.0005, confirmed after correction for hei ght and weight). Fractures had been sustained by 45% (10/22) of Turner 's patients for whom information was available, a high frequency compa red with controls (P = 0.014); half of these were at 'osteoporotic' si tes of fracture (wrist, vertebra, femoral neck). CONCLUSION Osteopenia in Turner's syndrome is not an intrinsic feature specific to this dis order, but results from extreme oestrogen deprivation. Early treatment with oestrogen is therefore recommended.