ESPE Abstracts (2016) 86 P-P1-828

A Study of Bone Health Index (BHI) in Girls with Turners Syndrome

Carley Frerichsa, Carly Jenkinsonb, Anne Povalla, Laurence Abernethya, Urmi Dasa, Renuka Ramakrishnana, Senthil Senniappana, Mohammed Didia & Jo Blaira


aAlder Hey Children’s Hospital NHS Foundation Trust, Liverpool, UK; bUniversity of Liverpool, Liverpool, UK


Background: Turners Syndrome (TS) is associated with osteoporosis in later life. ‘BoneXpert’ has enabled the automated assessment of bone age (BA) and Bone Health Index (BHI). Strong correlations between BoneXpert BHI and dual-energy x-ray absorptiometry and peripheral quantitative computed CT measurements are reported. BoneXpert produces a standard deviation score for BHI (BHI-SD) relative to a healthy cohort of children according to BA.

Objective and hypotheses: To investigate relationships between BHI SDS and hormone treatment in a cohort of girls with TS.

Method: All patients in our database with TS were reviewed. BA and BHI data analysed against age and therapy received. If patients had multiple readings over time they were grouped according to therapy at time of BHI analysis.

Results: females had data available and from these 57 x-rays were analysed. All results reported median (range). The BHI-SD of the 57 x-rays was −0.6 (−3.4 to 2.8). GH and oestrogen combined favours bone health with a significant difference in the BHI-SD of patients treated with GH and oestrogen versus those with no GH (P=0.01) and those with GH alone (P=0.0004).

Table 1. A comparison of age, TW2 BA and BHI-SD for various treatments (for abstract P1-P828).
No treatment (n=13)Growth Hormone (GH) (n=21)GH and oestrogen (n=22)Oestrogen (after GH) (n=1)
Age (yrs)9.19 (6.31–15.9)11.59 (6.25–17.3)15.47 (11.22–18.77)15.57
TW2 BA9.17 (6.43–13.71)11.08 (5.14–15.41)13.09 (9.4–14.7)15.71
BHI-SD−1.8 (−3.4–0.1)0.4 (−2.41–2.8)−0.75 (−2.5–0.7)−1.5

Conclusion: This is the first study to review BHI-SD in TS. BHI-SD seems to change over time. Treatment improved BHI-SD score and in particular oestrogen therapy in this study has the most significant impact. A larger cohort study is required to establish the exact nature of the relationship between BHI and treatment for TS.

Article tools

My recent searches

No recent searches.