Endocrine Abstracts

Turner syndrome (TS), resulting from complete or partial loss of X chromosome, occurs in 1 per 2000-2500 liveborn female neonates. Most patients with TS, especially those untreated with growth hormone, present with osteoporosis or osteopenia, and are at increased risk of bone fractures. Available evidence suggests that depletion of bone mass may be associated with inadequate level of physical activity, and consequently, with too low muscle mass and strength. The aim of the study was to analyse an association between muscle strength and bone mineral density in patients with TS, after consideration of selected hormonal and metabolic factors. The study included 52 subjects (age 28–45 years), among them 32 women with TS (45,X karyotype; Group A) and 20 controls (Group K). The list of analysed variables included body height, body weight, BMI, bone mineral density (BMD L1-4 and BMD Total), total body fat (BF) and visceral adipose tissue (VAT) volumes determined by means of DXA, hand grip strength measured with a manual dynamometer, and laboratory parameters: TSH, FT4, FSH, oestradiol, testosterone, DHEA-SO4, ACTH, cortisol, PTH, vitamin D3 concentrations, lipidogram, levels of glucose and insulin during OGTT. Patients from Group A presented with significantly lower left (P=0.001) and right handgrip strength (P<0.000), lower BMD (P<0.000), lower concentrations of testosterone (P<0.000) and DHEA-SO4 (P=0.006), larger VAT volumes (P=0.005), higher BMI (P=0.05), higher levels of insulin (P=0.026) and FSH (P=0.000). The study groups did not differ in terms of their TSH, fT4, ACTH and cortisol concentrations, and the only significant difference in lipidogram pertained to triglyceride level, higher in Group A (P=0.032). Right handgrip strength in Group A correlated significantly with BMD L1-4 (r=0.1318, P=0.0486), VAT volume (r=0.1478, P=0.0360) and BMD Total (r=0.1921, P=0.0154). These findings suggest that handgrip strength may constitute a predictor of osteoporosis in patients with TS.