Volumetric bone mineral density in young women with Turner's syndrome treated with estrogens or estrogens plus growth hormone

To explore the effects of estrogen replacement therapy (ERT) and recombinan t growth hormone (GH) treatment on bone mineral density (BMD) in Turner's s yndrome, we assessed volumetric BMD (vBMD), which is less dependent on body and bone sizes, in these patients at final height. The areal BMD (aBMD) wa s measured in 26 young women with Turner's syndrome (age range 17.5-25.0 ye ars) by dual-energy X-ray absorptiometry, and vBMD was calculated. Patients were subdivided as group 1 (n = 12; ERT alone) and group 2 (n = 14; GH + E RT). Years of estrogen exposure were not different between the groups (grou p 1: 6.4 +/- 1.5 years; group 2: 5.3 +/- 1.7 years); in group 2, GH therapy was 5.3 +/- 1.4 years. Final heights were significantly higher in group 2 than in group 1 (148.1 +/- 3.0 vs. 142.0 +/- 2.8 cm; p < 0.0001) as well as aBMD (1.073 +/- 0.118 vs. 0.968 +/- 0.122 g/cm(2); p < 0.04). vBMD was hig her in group 2 but not significantly different from group 1 (0.374 +/- 0.03 0 vs. 0.358 +/- 0.027 g/cm(3); p = 0.169). aBMD was reduced with respect to the normative values in both groups (group 1: -1.97 +/- 1.04 SDS, p < 0.00 01 vs. 0; group 2: -0.93 +/- 1.01 SDS, p < 0.005 vs. 0), whereas vBMD was n ot (group 1: -0.07 +/- 0.79 SDS; group 2: 0.42 +/- 0.82 SDS). Our data sugg est that: in Turner's syndrome GH administration improves final height and aBMD, but it does not significantly increase vBMD; aBMD reduction in Turner 's syn drome is likely due to the impaired growth and reduced bone size; Tu rner's patients on ERT from adolescence show vBMD values in the normal rang e in young adulthood. Copyright (C) 2000 S. Karger AG, Basel.