Effects of age at estrogen replacement therapy initiation on trabecular bone score in Japanese adults with Turner syndrome
Abstract
The effects of the age at estrogen replacement therapy (ERT) initiation on bone quality in Turner syndrome were evaluated using trabecular bone score. Early puberty ERT positively correlated with increase in bone quality. Early initiation of ERT is necessary for the acquisition of bone quality as well as bone density.Introduction Studies have reported associations between bone mineral density and estrogen replacement therapy (ERT) in Turner syndrome (TS) patients; however, few studies exist on the effect on bone quality. The aim of this study was to evaluate the effects of the age at ERT initiation on bone quality of Japanese TS patients, cross-sectionally and longitudinally.Methods Cross-sectionally, 95 TS patients were divided into three groups based on their age at initiation of ERT: A (12-14 years, 11 patients), B (15-17 years, 47 patients), and C (over 18 years, 37 patients). To assess bone quality, trabecular bone score (TBS) was used. The effects of age at initiation and duration of ERT on TBS were examined using multiple regression analysis. In the longitudinal study, 48 patients who underwent dual-energy X-ray absorptiometry multiple times were divided into three groups: D (12-14 years, 8 patients), E (15-17 years, 18 patients), and F (over 18 years, 22 patients). Each group was analyzed for the rate of change in TBS per year.Results Cross-sectionally, the TBS showed significant differences among the three groups (TBS A, 1.302; B, 1.299; C, 1.245) (p = 0.013); group C was significantly lower than B (p = 0.014); bone quality was degraded. Multiple regression analysis revealed that age at ERT initiation significantly affected the increase in TBS (p = 0.002). Longitudinally, the rate of change of TBS was not significantly different in the three groups (p = 0.73).Conclusion Early initiation of ERT may have positive effects on bone quality in TS. Large prospective studies will be needed.
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Earlier initiation of HRT affects BMD with higher BMD/better bone quality/greater trabecular bone score.
“Earlier initiation of HRT does affect BMD with higher BMD/better bone quality/greater trabecular bone score”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [354]
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
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- Authors
- Saito, S., Koga, E., Okada, Y., Tsuburai, T., Yoshikata, H., Miyagi, E., & Sakakibara, H.
- Affiliations
- Yokohama City University Medical Center (JP)
- Yokohama City University Hospital (JP)
- Corresponding author
- Sakakibara, H.
- Venue
- Osteoporosis International
- Published
- 2020-09-23
- Volume
- 32
- Issue
- 4
- Pages
- 671-680
- ISSN
- 0937-941X (ISSN-L)
- 1433-2965
- OpenAlex
- W3088635917
- Cited by
- 11
- References
- 34
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Osteoporosis International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- Turner syndrome, estrogen replacement therapy, age at treatment initiation, trabecular bone score, bone quality, precocious puberty, bone mineral density, Japanese women
- MeSH terms
- Cancellous Bone, Adult, Female, Humans, Japan, Longitudinal Studies, Lumbar Vertebrae, Prospective Studies, Turner Syndrome, Absorptiometry, Photon, Bone Density, Estrogen Replacement Therapy
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