This Article Full Text Full Text (PDF) All Versions of this Article: 91/11/4302    most recent Author Manuscript (PDF) Submit a related Letter to the Editor View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ari, M. Articles by Bondy, C. A. Search for Related Content PubMed PubMed Citation Articles by Ari, M. Articles by Bondy, C. A. Related Collections Calcium and Bone Metabolism Female Endocrinology Pediatric Endocrinology

The Effects of Growth Hormone Treatment on Bone Mineral Density and Body Composition in Girls with Turner Syndrome

Developmental Endocrinology Branch, National Institute of Child Health and Human Development (M.A., V.K.B., C.A.B.), and Warren G. Magnuson Clinical Center Radiology Department (S.H.), National Institutes of Health, Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Carolyn Bondy, M.D., Chief Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, BG10, Room 1E-3330, Rockville, Maryland 20892. E-mail: bondyc{at}mail.nih.gov.

Background: Many girls with Turner syndrome (TS) are treated with GH to increase adult height. In addition to promoting longitudinal bone growth, GH has effects on bone and body composition.

Objective: The objective was to determine how GH treatment affects bone mineral density (BMD) and body composition in girls with TS.

Method: In a cross-sectional study, we compared measures of body composition and BMD by dual energy x-ray absorptiometry, and phalangeal cortical thickness by hand radiography in 28 girls with TS who had never received GH and 39 girls who were treated with GH for at least 1 yr. All girls were participants in a National Institutes of Health (NIH) Clinical Research Center (CRC) protocol between 2001 and 2006.

Results: The two groups were similar in age (12.3 yr, SD 2.9), bone age (11.5 yr, SD 2.6), and weight (42.8 kg, SD 16.6); but the GH-treated group was taller (134 vs. 137 cm, P = 0.001). The average duration of GH treatment was 4.2 (SD 3.2) yr (range 1–14 yr). After adjustment for size and bone age, there were no significant differences in BMD at L1–L4, 1/3 radius or cortical bone thickness measured at the second metacarpal. However, lean body mass percent was higher (P < 0.001), whereas body fat percent was lower (P < 0.001) in the GH-treated group. These effects were independent of estrogen exposure and were still apparent in girls that had finished GH treatment at least 1 yr previously.

Conclusions: Although GH treatment has little effect on cortical or trabecular BMD in girls with TS, it is associated with increased lean body mass and reduced adiposity.

eLetters: