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Bone size and density measurements in prepubertal children with Turner syndrome prior to growth hormone therapy

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Abstract

Summary

Using computed tomography (CT), we found the decreases in bone size of vertebrae and femur, cortical bone area (CBA) of femur and bone density (BD) of vertebrae in prepubertal female with Turner syndrome (TS) compared to those of controls.

Introduction

Bone mineral density results from previous studies utilizing single-photon absorptiometry (SPA) or dual-energy X-ray absorptiometry (DXA) in children with TS are controversial. The present study used CT to assess the differences in cancellous and cortical bone size and BD between prepubertal TS patients prior to growth hormone therapy and historical age and ethnicity-matched female controls.

Methods

Anthropometrics and CT bone measurements including cross-sectional area (CSA) and BD of lumbar vertebrae and femur and CBA of femur in prepubertal TS females were reviewed and compared with those in controls.

Results

Twenty-two prepubertal TS patients had delayed bone age, were shorter and lighter than controls (Ps < 0.001). After adjusting for weight, height and skeletal age, vertebral BD and CBA of the femur were lower in patients than in controls (P < 0.001 and P = 0.021, respectively). However, after additional adjusting for puberty, results were not different from controls. While a positive correlation between vertebral BD and age was noted in controls (r = 0.367, P = 0.092), a significant negative correlation was noted in patients (r = −0.615, P = 0.002).

Conclusions

While the decrease in vertebrae and femur sizes of patients with TS appeared to be secondary to their small body size, the decreased BD of vertebrae and CBA of femur were likely secondary to estrogen deficiency.

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Acknowledgments

The authors would like to thank Frederick Dorey, Ph.D. for his support in statistical analysis and Norma Castaneda for her assistance in data collection. This study was partially supported by research grants from EMD Serono, Inc.

Conflicts of interest

N.N., D.S, S.R., V.S., and G.C. have nothing to declare. P.P. is currently on the speakers bureau for EMD, Serono, Inc., Genentech, Inc., Endo Phamaceuticals, Inc. and serves as a consultant/advisor to Serono, Inc.

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Authors and Affiliations

  1. Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, University of Southern California, Los Angeles, CA, 90027, USA

    P. Pitukcheewanont, N. Numbenjapon, D. Safani, S. Rossmiller & G. Costin

  2. Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA

    V. Gilsanz

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  1. P. Pitukcheewanont
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  2. N. Numbenjapon
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  3. D. Safani
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  4. S. Rossmiller
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  5. V. Gilsanz
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  6. G. Costin
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Correspondence to P. Pitukcheewanont.

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Pitukcheewanont, P., Numbenjapon, N., Safani, D. et al. Bone size and density measurements in prepubertal children with Turner syndrome prior to growth hormone therapy. Osteoporos Int 22, 1709–1715 (2011). https://doi.org/10.1007/s00198-010-1375-2

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  • DOI: https://doi.org/10.1007/s00198-010-1375-2

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