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Cited by 78Menopause: Health Impacts and TreatmentsGenetic and Clinical Aspects of Sex Determination and Chromosomal AbnormalitiesHormonal and reproductive studies

Choosing an oestrogen replacement therapy in young adult women with Turner syndrome

Guttmann, Hadassah, Weiner, Zeev, Nikolski, Eugenia, Ish‐Shalom, Sophia, Itskovitz‐Eldor, Joseph, Aviram, Michael, Reisner, Shimon, Hochberg, Ze'ev·2001·Clinical Endocrinology
DOI 10.1046/j.1365-2265.2001.01181.x
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Abstract

OBJECTIVE: Hormone replacement therapy (HRT) is prescribed to most patients with Turner syndrome (TS) although its use in adult TS patients has not been scientifically evaluated. The present study was performed to compare the short-term effects in adult women with Turner syndrome of low-dose oral conjugated oestrogen (0.625 mg, CE) with relatively high dose ethinyl oestradiol (30 microg, EE2); both combined with an oral progestin. DESIGN AND PATIENTS: After 4 months off HRT, 17 young, otherwise healthy women with TS were enrolled in a random, unblinded, crossover study of the two oestrogenic preparations, each given for 6 months. MEASUREMENTS: We compared parameters of oestrogenic activity that would cover immediate changes in hormone levels, biochemistry, bone turnover, uterine and cardiac variables, which constitute risk factors for later development of diabetes, atherosclerosis, osteoporosis and aortic dissection. RESULTS: Serum FSH returned to normal follicular phase levels only on the EE2 regimen. The hypotrophic endometria normalized with either of the two oestrogen regimens with no excessive hypertrophy. Hyperinsulinaemia was suppressed to normal by both EE2 and CE. PTH and 1,25-dihydroxyvitamin D levels increased on HRT (EE2 > CE), and phosphorus decreased. Alkaline phosphatase, osteocalcin and urinary deoxypyridinoline cross-links (DPD) were high off therapy; the former two suppressed to high-normal levels on the EE2 regimen, but not on CE, and DPD did not normalize with either HRT. Lipid profiles in these young TS patients were normal. Liver enzymes were mildly elevated off therapy and suppressed to normal levels on both regimens, but more so with EE2. CONCLUSIONS: The risk factors embodied in hyperinsulinaemia and enhanced bone turnover which, ultimately, have consequences for TS morbidity, are minimized by HRT. In the short term, neither regimen is effective for bone turnover in adult women with Turner syndrome.

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Authors
Guttmann, H., Weiner, Z., Nikolski, E., Ish‐Shalom, S., Itskovitz‐Eldor, J., Aviram, M., Reisner, S., & Hochberg, Z.
Affiliations
Rambam Health Care Campus (IL)
ORCID
Hochberg, Ze'ev
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2001-02
Volume
54
Issue
2
Pages
159-164
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1046/j.1365-2265.2001.01181.x
OpenAlex
W2079591877
Cited by
78
References
20
Citations by year
2025: 1 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 2
FWCI
2.77
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 322 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
Turner syndrome, estrogen replacement therapy, conjugated equine estrogens, ethinyl estradiol, progestins, bone turnover, hyperinsulinemia, parathyroid hormone, 1,25-dihydroxyvitamin D, follicle-stimulating hormone, endometrial thickness, osteocalcin, urinary deoxypyridinoline, atherosclerosis risk factors, aortic dissection risk, young adult women
MeSH terms
Adolescent, Adult, Amino Acids, Aortic Aneurysm, Drug Administration Schedule, Echocardiography, Endometrium, Estrogens, Conjugated (USP), Ethinyl Estradiol, Female, Humans, Liver Function Tests, Progestins, Turner Syndrome, Biomarkers, Osteocalcin, Estrogen Replacement Therapy, Bone Remodeling, Cross-Over Studies

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