Background: Increased fracture risk and decreased bone mineral density (BMD) have been demonstrated by several studies in Turner syndrome (TS). However, longitudinal data on BMD development in childhood and adolescence and a reliable densitometric predictor of fractures in TS are still lacking.
Objective and hypotheses: Our aim was to longitudinally assess BMD in paediatric TS patients and test whether trabecular BMD development over six years of observation can predict fracture incidence in these patients.
Method: Peripheral quantitative CT (pQCT) scans of the forearm were performed in 33 girls with TS (median age 12.1 year, range 6.016.4 year) every second year over a period of six years. Trabecular volumetric BMD (vBMD) and cortical thickness were assessed at the 4 and 65% site, respectively. Z-scores were calculated based on published references. Participants fracture history was acquired through an interview.
Results: Three girls sustained fracture during the follow up. Mean six-year decrease in trabecular vBMD Z-score was 1.0±1.2 (P<0.001). Girls with incident fractures didnt have larger six-year decrease in trabecular vBMD Z-score when compared to girls without a fracture (−0.35±0.37 and −1.09±1.20; P=0.051). Cortical thickness Z-score remained the same over the six-year period (−0.31±0.94, P=0.09) and this didnt differ between girls with and without an incident fracture (−0.30±0.52 and −0.31±1.08; P=0.97).
Conclusion: Our study demonstrates that trabecular vBMD decreases with age in paediatric patients with TS, an effect possibly related to the hypergonadotropic hypogonadism, while cortical thickness seems to be stable over the childhood and adolescence. None of the two pQCT-derived parameters proved to be useful in the incident fracture prediction over the six-year observation duration.
Funding information: This work was supported by the Project for Conceptual Development of Research Organisation 00064203 (University Hospital Motol, Prague, Czech Republic), sponsored by Ministry of Health, Czech Republic.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology