CONTEXT: Patients with Turner's syndrome have normal bone mineral density by dual energy X-ray absorptiometry (DXA), but a predisposition for fractures. Quantitative ultrasonography (QUS) measures cortical bone strength. OBJECTIVE: To compare QUS with DXA in patients with Turner's syndrome. PATIENTS AND METHODS: Twenty-seven Turner's syndrome patients, aged 21.1 +/- 6.3 years (mean +/- SD), were evaluated by DXA, measuring two-dimensional bone mineral density (BMD), and QUS, measuring speed of sound (SOS) of the radius and tibia. The results were compared to sex- and age-matched (Ctr A, n = 53) and height-matched (Ctr B, n = 34) control groups. RESULTS: Fracture incidence per 1000 women years was 4.76 in Ctr A, 5 in Ctr B and 7.69 in Turner's patients. In Turner's syndrome patients, QUS results were significantly lower than in controls, whereas DXA Z-scores were not different from reference values. Correlation between tibia and radius SOS and height and age in controls (P < 0.0001) was not evident in Turner's syndrome. Oestrogen or growth hormone therapy had no effect on either QUS or DXA parameters. CONCLUSIONS: Bone fragility in Turner's syndrome is reflected by low SOS but not by DXA BMD. Low QUS, which assesses the cortical bone only, supports a defect in cortical bone in Turner's syndrome. Lack of SOS correlation with age, height and hormonal therapy in Turner's syndrome suggests a primary bone defect, rather than enhanced resorption of endocrine origin.
CONTEXT: Patients with Turner's syndrome have normal bone mineral density by dual energy X-ray absorptiometry (DXA), but a predisposition for fractures. Quantitative ultrasonography (QUS) measures cortical bone strength. OBJECTIVE: To compare QUS with DXA in patients with Turner's syndrome. PATIENTS AND METHODS: Twenty-seven Turner's syndromepatients, aged 21.1 +/- 6.3 years (mean +/- SD), were evaluated by DXA, measuring two-dimensional bone mineral density (BMD), and QUS, measuring speed of sound (SOS) of the radius and tibia. The results were compared to sex- and age-matched (Ctr A, n = 53) and height-matched (Ctr B, n = 34) control groups. RESULTS: Fracture incidence per 1000 women years was 4.76 in Ctr A, 5 in Ctr B and 7.69 in Turner's patients. In Turner's syndromepatients, QUS results were significantly lower than in controls, whereas DXA Z-scores were not different from reference values. Correlation between tibia and radius SOS and height and age in controls (P < 0.0001) was not evident in Turner's syndrome. Oestrogen or growth hormone therapy had no effect on either QUS or DXA parameters. CONCLUSIONS: Bone fragility in Turner's syndrome is reflected by low SOS but not by DXA BMD. Low QUS, which assesses the cortical bone only, supports a defect in cortical bone in Turner's syndrome. Lack of SOS correlation with age, height and hormonal therapy in Turner's syndrome suggests a primary bone defect, rather than enhanced resorption of endocrine origin.
Authors: Christian Trolle; Britta Hjerrild; Line Cleemann; Kristian H Mortensen; Claus H Gravholt Journal: Endocrine Date: 2011-12-07 Impact factor: 3.633
Authors: K D Williams; J Blangero; M C Mahaney; J Subedi; B Jha; S Williams-Blangero; B Towne Journal: Osteoporos Int Date: 2015-04-11 Impact factor: 4.507
Authors: Carmen M T Lageweg; Mayke E van der Putten; Johannes B van Goudoever; Ton Feuth; Martin Gotthardt; Arno F J van Heijst; Viola Christmann Journal: Bone Rep Date: 2018-01-28