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Bone Mineral Density in Adult Patients with Turner's Syndrome: Analyses of the Effectiveness of GH and Ovarian Steroid Hormone Replacement Therapies

机译:成人特纳综合征患者的骨矿物质密度:生长激素和卵巢类固醇激素替代疗法的有效性分析

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摘要

To analyze the effects of treatments with GH and cyclic estrogen/progesterone (E/P) replacement on bone mineralization in patients with Turner's syndrome (TS), bone mineral density (BMD) was measured longitudinally. BMDs of the whole body and the lumbar spine in 16 adult female patients with TS (17-38 year old; 0-20 years by length of E/P treatment) were assessed using dual energy X-ray absorptiometry one to 5 times over a treatment period of up to 7 years maximum. GH treatment was performed in 9 cases (GH group), but not in the remaining 7 (non-GH group). E/P replacement therapy was initiated in all patients after they finished GH administration. The BMDs of both the whole body and the lumbar spine in the patients with TS were significantly less than those in age-matched normal subjects, and did not improve with E/P treatment. Although there were no differences in final body height and age at the beginning of E/P administration between the GH and non-GH groups, whole body BMD in the GH group was significantly lower than that in the non-GH group. These results indicate that GH administration in childhood and adolescence and E/P treatment in adulthood did not increase bone mineralization in the TS patients. Therefore, we can conclude that the optimal protocol of hormonal replacement therapy with GH and E/P during childhood and adolescence should be established as soon as possible.
机译:为了分析生长激素和循环雌激素/孕酮(E / P)替代疗法对特纳综合征(TS)患者骨矿化的影响,纵向测量了骨矿物质密度(BMD)。使用双能X线吸收法对16名成年女性TS(17-38岁; E / P治疗时间为0-20年)的成年女性的全身和腰椎BMD进行1-5次评估。治疗期最长可达7年。 GH治疗9例(GH组),其余7例(非GH组)未进行。所有患者在完成GH给药后均开始E / P替代治疗。 TS患者的全身和腰椎BMD均显着低于年龄匹配的正常受试者,并且E / P治疗并没有改善。尽管GH组和非GH组在开始E / P给药后的最终身高和年龄没有差异,但GH组的全身BMD明显低于非GH组。这些结果表明,在儿童期和青春期施用GH和在成年期进行E / P治疗并没有增加TS患者的骨矿化。因此,我们可以得出结论,应尽快建立在儿童和青春期用GH和E / P进行激素替代治疗的最佳方案。

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