Endocrine Abstracts

Objective: Growth hormone (GH) and sex hormone replacement therapy (SHRT) are standard treatment for patients with Turner syndrome (TS) that enhances bone mineral density (BMD), puberty, and quality of life. We aimed to evaluate the efficacy of SHRT and GH on BMD in TS patients.

Methods: Cross-sectional study was performed in LUHS Kauno Klinikos in 2014–2018. 27 females with TS were enrolled. BMD and Z score of the lumbar vertebrae and femur were measured by dual - energy X-ray absorptiometry (DEXA) and compared between these groups: users and non-users of SHRT; natural estrogen (NE) users vs. combined oral contraceptive pills (COC’s) users; initiated with SHRT <15 years vs. >15 years; patients who received treatment with GH vs. not treated; patients who had and did not have spontaneous puberty.

Results: BMD and Z score of femur was higher in patients who did not use SHRT (BMD 0.9 (0.81 − 1.12) vs. 0.81 (058 − 1.04), P=0.049; Z score −0.2 (−0.9 – 2.3) vs. − (−2.9 – 0.8), P=0.049). No significant differences in BMD and Z score depending on SHRT initiation (<15; >15 years), between NE and COC’s users (P>0.05) were found. Femur BMD and Z score were higher in patients who underwent spontaneous puberty (BMD 0.91 (0.73 – 1.2) vs. 0.81 (0.58 – 1.04), P=0.038, Z score −0.15 (−1.7 − 2.3) vs. −1 (−2.9 − 0.8) P=0.036). No significant differences were found between users and non-users of GH (P>0.05).

Conclusions: SHRT and GH did not influence BMD in females with TS. Spontaneous puberty had positive effect on BMD.