Estradiol (EE₂) and Growth Hormone (GH) Increase Bone Deposition in Girls with Turner's Syndrome † 400

Osteopenia is common in Turner's syndrome. Despite the proven association between EE₂ deficiency and osteoporosis, EE₂ treatment in Turner's syndrome does not normalize bone mineral content. Using stable isotopes of calcium (Ca) we determined Ca fractional absorption (α), balance (Vbal), and bone deposition (Vo+) in 7 children (10 - 16 y old) and 4 adults (16 - 34 y old) with Turner's syndrome. Each subject was studied before and after 3 months of GH treatment (0.1 mg/kg/d in adults and 0.05 mg/kg/d in children). All adults were treated with EE₂ (50 μg/d) and progesterone before and throughout the study. Three children received no EE₂ and 4 children were treated with low-dose (5μg/d) EE₂ in combination with GH. The results, treatment minus baseline (Δ), are summarized in the table below. GH did not affect Ca kinetics in adults already on a regimen of EE₂/progesterone replacement. GH alone also did not affect Ca kinetics in children. However, addition of EE₂ to GH treatment in children resulted in a significant increase in Ca absorption, Ca balance and Ca turnover. Addition of low-dose estrogen to a regimen of GH may improve bone deposition and calcium balance in girls with Turner's syndrome.

Table 1 No caption available.