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Bone, body composition altered in Turner syndrome despite treatment
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BOSTON — Among women with Turner syndrome, bone and body composition alterations are evident even when growth hormone and estrogen therapies are used.
“Women with Turner syndrome are at increased risk of osteroporosis, which is thought to arise from ovarian failure-related hypoestrogenism, but alterations in body composition may also be operative,” the researchers wrote. “Current [Turner syndrome] recommendations include childhood growth hormone for short stature and estrogen replacement started in the adolescent years, but the estrogen dose and timing that optimized bone mineral accrual is not known.”
Jacquelyn A. Hatch-Stein, MD, a pediatric endocrinology fellow at The Children’s Hospital of Philadelphia, and colleagues six women (mean age, 19.9 years) with Turner syndrome and six controls (mean age, 20.8 years) to determine whether bone mineral content and bone mineral density are reduced and body composition is altered in women with Turner syndrome despite treatment with growth hormone and estrogen.
Jacquelyn A. Hatch-Stein
Both groups had similar lean body mass index z scores, fat mass and fat mass index z scores. The Turner syndrome group had lower lean body mass compared with controls (P = .04). After adjustment for height, the Turner syndrome group had higher fat mass (P = .01) and fat mass index z score (P = .009) compared with controls; lean body mass and lean body mass index z scores were similar.
Bone mineral content height-adjusted z scores were lower in the Turner syndrome group (P = .02) compared with controls even after adjustment for lean body mass index z score (P = .04).
No difference was found for visceral fat area; however, with increasing BMI, the Turner syndrome group had more visceral fat area for a given BMI compared with controls (P = .059).
“The dose and timing of estrogen needed to optimize bone accrual in [Turner syndrome] has yet to be determined and requires further investigation,” the researchers wrote. “In addition, increased visceral fat for a given BMI in [Turner syndrome] may indicate the need to reevaluate the appropriate usage of BMI as a predictor of cardiovascular risk in this population.” – by Amber Cox
Reference:
Hatch-Stein. Poster FRI 003. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2016; Boston.
Disclosure: The researchers report no relevant financial disclosures.