Fracture risk and bone mineral density in Turner syndrome
Abstract
Bone health is a major lifelong concern in caring for women and girls with Turner syndrome (TS). There is an approximately 25% increase in fracture risk most of which is related to medium or high impact trauma. The long bones, especially of the forearm are predominantly affected. This fact may be due to a selective cortical bone deficiency in TS which is unrelated to hypogonadism. In addition, lack of adequate estrogen replacement can lead to trabecular bone deficiency and increase in vertebral compression fractures after age 45. Evaluation of bone density by dual X-ray absorptiometry (DEXA) is important, however, it should be used judiciously in TS in view of its inherent tendency to underestimate the bone density of people with short stature. Bone size-independent methods, such as QCT or volumetric transformation of DEXA data should be used in individuals shorter than 150 cm. Achieving optimal bone density is of critical importance for fracture prevention in TS, and should be pursued by timely introduction of hormone replacement therapy, adequate dose of estrogens during the young adult life, optimal calcium and vitamin D intake and regular physical exercise. In addition, other measures to prevent fall and trauma should be considered, including optimizing hearing and vision, avoiding contact sports and exercise to improve coordination.
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A 25% increase in fracture rate exists in TS.
“It is estimated that 23.8% of adults with TS have osteoporosis384 and a 25% increase in fracture rate exists.735,736”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [735]
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
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- Authors
- Bakalov, V. K., & Bondy, C. A.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Bondy, Carolyn A.
- Venue
- Reviews in Endocrine and Metabolic Disorders
- Published
- 2008-04-15
- Volume
- 9
- Issue
- 2
- Pages
- 145-151
- ISSN
- 1389-9155 (ISSN-L)
- 1573-2606
- OpenAlex
- W2033782717
- Cited by
- 70
- References
- 52
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 8 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 6
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Reviews in Endocrine and Metabolic Disorders (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, fracture risk, bone mineral density, vertebral compression fractures, estrogen replacement therapy, hypogonadism, short stature, dual-energy X-ray absorptiometry, quantitative computed tomography, fall prevention, calcium and vitamin D intake, physical activity
- MeSH terms
- Humans, Risk Factors, Turner Syndrome, Bone Density, Hormone Replacement Therapy, Fractures, Bone
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