ESPE Abstracts (2019) 92 T8

Bone Mineral Density (BMD) in Women with Turner Syndrome (TS) from the DSD-LIFE Cohort, an Epidemiological Study

Catherine Pienkowski1,2, Yasmine El Allali2, Audrey Cartault1,2, Perrine Ernoult1, Solange Grunenwald1, Nicole Reish3, Hedi Claahsen-Van Der Grinten4, Jean-Pierre Salles2


1Reference Centre of Rare Gynaecology Disease; Paediatric Hospital, University hospital, Toulouse, France. 2Endocrinology, Obesity, Bone diseases, and Medical Gynaecology Paediatric Unit, Children Hospital, University hospital, Toulouse, France. 3Oberärztin, Medizinische Klinik IV, Klinikum der Universität München, Ziemssenstraße 1 80336 München, München, Germany. 4Afdeling kinderendocrinologie, Amalia kinderziekenhuis, Radboud Universiteit Medisch Centrum, Nijmegen, Netherlands


Aim: The objective of the study was to determine bone mineralisation density in Turner syndrome (TS) from DSD life cohort, and to analyse the trabecular (lumbar spine = LS) and cortical bone (femoral neck = FN) mineralisation.

Materials and Methods: This study was part of the DSD-LIFE study, a cross-sectional clinical outcome study of the BMD of TS adult patients from paediatric cohorts. BMD of the LS and FN were expressed in g/cm2 and in women's T scores. Osteoporosis was defined for T score < -2.5 and osteopenia between -1 and -2.5 T score.

Results: In the DSD-LIFE cohort, 113 patients with TS had data of BMD in 4 European countries (Germany n= 34, Netherlands n=41, Poland n=3 and France n=39). History of fracture was found for 8.3% patients. 10.9% of the cohort presented osteoporosis.

Mean age was 30.15 ± 11.1 years. Mean height was 152.4 ± 6.9 cm, mean weight was 59.1 ± 13.6 kg and mean BMI was 25.5 ± 5.6 kg/m2. Mean gynaecological age (GA) (number of years after menarche) was 14.7 ±10 years with a mean age of puberty induction at 14 years ±3 years.

The median for BMD of FN was 0.84g/cm² (IQR 0.75 ; 0.92 g/cm² ) with T score of -0.7 SD ( IQR -1.5 ; -0.2 SD). The median for BMD of LS was 1.0 g/cm² (IQR 0.93 ; 1.09g/cm² ) with T score of -0.6 SD (IQR -1.4 ; -0.1 SD). No difference was noted according to karyotype (45X n=58, and no monosomy n=59). No difference was noted according to induction (n=55) or spontaneous puberty (n=26) and according the hormonal treatment. DMO decrease significantly with age and with GA for the FN (r=-0.2181, P=0.0450) but not for LS. DMO (FN or LS) was not significantly different between the group of woman under 150 cm and the group of woman above 150 cm.

Conclusion: The data of this study report a positive efficiency of estrogenic substitution on bone in TS adult and highlights the need to encourage hormonal treatment compliance for those patients.

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