Abstract：
Turner syndrome (TS) is associated with a high risk of fracture due to low bone mineral density (BMD). While hypogonadism is known to play a role in decreasing BMD, other factors have not been studied well. Focusing on diet, exercise, and bone metabolism markers, the present, multicentric, prospective, observational study aimed to identify factors contributing to decreased BMD in TS. In total, 48 patients with TS aged between 5 and 49 years comprising a pre-pubertal group (n = 9), a cyclical menstruation group (n = 6), and a hormone replacement therapy (HRT) group (n = 33) were enrolled. The cyclical menstruation group and the HRT group were referred to collectively as the post-pubertal group. The bone mineral apparent density (BMAD) Z-score was higher in the pre-pubertal group than in the post-pubertal group (-0.3 SD vs. -1.8 SD; p = 0.014). Within the post-pubertal group, the median BMAD Z-score was -0.2 SD in the cyclical menstruation group and -2.3 SD in the HRT group (p = 0.016). Spearman\'s rank correlation revealed no correlation between the BMAD Z-score and bone metabolism markers. No significant relationship was observed between the BMAD Z-score and either the vitamin D sufficiency rate or the step sufficiency rate. A negative correlation was found between BMAD Z-score and serum sclerostin in the pre-pubertal group and serum FSH in the post-pubertal group. In conclusion, the present study found no relationship between the vertebral BMAD Z-score and diet or exercise habits in TS, indicating that estrogen deficiency is the chief reason for low BMD in TS.
摘要：
特纳综合征（TS）与低骨密度（BMD）导致的高骨折风险相关。虽然已知性腺机能减退在降低BMD中起作用，其他因素没有得到很好的研究。专注于饮食，锻炼,和骨代谢标志物，现在,多中心,prospective,观察性研究旨在确定导致TS骨密度降低的因素。总的来说,48例年龄在5至49岁之间的TS患者，包括青春期前组（n=9），周期性月经组（n=6），纳入激素替代疗法（HRT）组（n=33）。周期性月经组和HRT组统称为青春期后组。青春期前组的骨矿物质表观密度（BMAD）Z评分高于青春期后组（-0.3SDvs.-1.8标准差；p=0.014)。在青春期后群体中，周期性月经组的BMADZ评分中位数为-0.2SD,HRT组为-2.3SD(p=0.016).Spearman的等级相关性显示BMADZ评分与骨代谢标志物之间没有相关性。在BMADZ评分与维生素D充足率或步骤充足率之间均未观察到显着关系。青春期前组的BMADZ评分和血清硬化蛋白与青春期后组的血清FSH呈负相关。总之,本研究发现，TS的椎骨BMADZ评分与饮食或运动习惯之间没有关系，表明雌激素缺乏是TS骨密度低的主要原因。
