Long-term hormone replacement therapy preserves bone mineral density in Turner syndrome.

Context: Reduced bone mineral density (BMD) and increased risk of fractures are present in many women with Turner syndrome (TS). Objective: Examine longitudinal changes ill BMD in TS and relate changes to biochemical parameters. Design: Prospective, pragmatic, and observational Study Examinations at baseline and follow-up (5.9 +/- 0.7 years). Setting: Tertiary hospital. Participants: Fifty-four women with TS (43.0 +/- 9.95 years). Interventions: Hormone replacement therapy (HRT) and calcium and vitamin D supplementation. Main outcome measures: BMD (g/cm(2)) measured at lumbar spine, hip, and the non-dominant forearm. Bone formation and resorption markers. sex hormones. IGF1, and maximal Oxygen uptake. Results: At follow-up. forearm BMD). radius ultradistal BMD. and hip BMD remained Unchanged, radius 1/3 BMD declined (0.601 +/- 0.059 vs 0.592 +/- 0.059, P = 0.03). while spine BMD increased (0.972 +/- 0.139 vs 1.010 +/- 0.144, P < 0.0005). Bone formation markers did not change over time in TS. Bone resorption markers decreased over time in TS. Testosterone. IGF1. and maximal oxygen uptake was significantly reduced in TS. Conclusion: Longitudinal changes in BMD in TS were slight. BMD can be maintained at most sites ill well-informed women with TS. being encouraged to maintain a healthy lifestyle. including HRT and intake of calcium and vitamin D.