Bone Mineral Status in Turner Syndrome

Bone mineral density (BMD) was studied in 22 young girls with Turner syndrome (5-22 year) in relation to pubertal status and karyotype. BMD of trabecular and cortical bones were evaluated by dual-energy X-ray absorptiometry of the lumbar spine (L2-4 BMD) and II metacarpal bone microdensitometry (ΣGS/D), respectively. Furthermore, 6 patients treated with growth hormone (GH) were analyzed longitudinally.The mean Z scores of L2-4 BMD and ΣGS/D were -1.485 and -1.613, respectively. The mean Z scores of L2-4 BMD and IGS/D corrected for bone age were -1.199 and -1.104, respectively. There was no significant difference in BMD between those who eventually developed puberty and those who did not. No difference in either L2-4 BMD or ΣGS/D was found between the 14 patients with karyotype monosomy X and the 7 patients with other karyotypes. GH treatment improved the BMD of cortical bone; improvement was marked in patients treated from an early age.These findings show that mineralization of both trabecular and cortical bone is impaired and that estrogen deficiency is not the only cause of osteopenia in this disease. Moreover, GH may be an effective treatment for osteopenia as well as for short stature.