A 6-Year Follow-Up of Fracture Incidence and Volumetric Bone Mineral Density Development in Girls With Turner Syndrome
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
29300907
DOI
10.1210/jc.2017-02381
PII: 4780815
Knihovny.cz E-resources
- MeSH
- Time Factors MeSH
- Child MeSH
- Estrogens therapeutic use MeSH
- Incidence MeSH
- Bone Density drug effects MeSH
- Humans MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Osteoporotic Fractures epidemiology etiology MeSH
- Tomography, X-Ray Computed methods MeSH
- Radius diagnostic imaging MeSH
- Risk Factors MeSH
- Growth Hormone therapeutic use MeSH
- Turner Syndrome complications drug therapy physiopathology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Estrogens MeSH
- Growth Hormone MeSH
CONTEXT: Patients with Turner syndrome (TS) are at risk for osteoporotic fractures. OBJECTIVE: The aims of this study were to assess the incidence of clinically important fractures in girls with TS and prospectively describe the development of volumetric bone mineral density (BMD). DESIGN: Peripheral quantitative computerized tomography (pQCT) of the radius every other year over the 6 years of observation. SETTING: Government-funded university referral center. PARTICIPANTS: Thirty-two girls with TS, aged 6 to 16 years, were included in the analyses. Fracture incidence was compared with the data in the general population. Bone density and strength were compared with data from 185 healthy girls. OUTCOMES: The main clinical outcome was the fracture occurrence. The secondary outcomes were the changes in Z-scores of the bone parameters. RESULTS: Three girls with TS sustained four fractures during 6 years of observation. The fracture rate in TS was not substantially higher than the downward-biased fracture-rate estimate from age-matched, healthy controls (P = 0.48). Whereas the trabecular BMD Z-score decreased with age (β estimate -0.21 ± 0.04, P < 0.001), total bone cross-sectional area correspondingly increased (+0.16 ± 0.04, P < 0.001), which led to normal bone strength. A positive history of incident fractures was not significantly associated with any of the pQCT-derived bone parameters. CONCLUSIONS: Current pediatric TS patients that are treated with growth hormone and estrogens are not at risk for osteoporotic fractures. Low BMD in TS may be counterweighted by enlarged bone radius, which leads to normal bone strength at the appendicular skeleton.
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