A cross-sectional and longitudinal analysis of trabecular bone score in adults with Turner syndrome
Open accessAbstract
Context: Turner syndrome (TS) is associated with short stature, gonadal failure, and fractures. Spinal trabecular bone score (TBS) is a novel bone imaging modality that has not been evaluated in TS. Objective: To evaluate TBS in TS and its association with bone mineral density (BMD), prevalent fracture, and risk factors. Design and Setting: Longitudinal study of TS from a single tertiary hospital between 2006 and 2017. Patients or Other Participants: Fifty-eight subjects with TS aged 20 to 49 years who underwent dual-energy X-ray absorptiometry (DXA). Main Outcome Measures: TBS, DXA parameters, and prevalent fractures were investigated. Results: Normal, partially degraded, and degraded TBSs were observed in 39 (67%), 15 (26%), and four (7%) subjects, respectively. High rates of prescribed estrogen replacement therapy (ERT) with stable TBS and BMD were observed during follow-up. TBS was positively correlated with spine and femoral neck (FN) BMD and Z-scores (all P < 0.05) and negatively correlated with age (-0.004 per year; P = 0.014) and delay in ERT initiation in women with primary amenorrhea (-0.010 per year; P < 0.001). Fractures were present in 17 (31%) subjects. Low TBS had a significantly higher area under the receiver operator curve for predicting prevalent fracture than low bone mass at either the spine or FN (P < 0.05). Subjects with no history of fracture were more likely to have a normal TBS (P = 0.023). Conclusions: BMD and TBS can be preserved with early initiation and continued use of ERT. TBS may provide additional fracture risk prediction to standard DXA parameters in TS and needs to be validated in larger prospective studies.
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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 [353]
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- Authors
- Nguyen, H. H., Wong, P., Strauss, B. J., Ebeling, P. R., Milat, F., & Vincent, A.
- Affiliations
- Monash Health (AU)
- Hudson Institute of Medical Research (AU)
- Monash University (AU)
- Corresponding author
- Nguyen, Hanh H
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2018-07-17
- Volume
- 103
- Issue
- 10
- Pages
- 3792-3800
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2883710281
- Cited by
- 27
- References
- 42
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 4
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen-Osteoporosis Australia-Australian New Zealand Bone & Mineral Society
- National health Medical Research Council Early Career Fellow
- 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, trabecular bone score, bone mineral density, fracture risk, estrogen replacement therapy, primary amenorrhea, osteopenia, femoral neck, bone microarchitecture, fracture risk prediction
- MeSH terms
- Cancellous Bone, Adult, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Longitudinal Studies, Middle Aged, Osteoporosis, Prognosis, Turner Syndrome, Bone Density, Spinal Fractures, Young Adult, Osteoporotic Fractures
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