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Hormones

, Volume 13, Issue 3, pp 353–360 | Cite as

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome

  • Francesco Vierucci
  • Marta Del Pistoia
  • Paola Erba
  • Giovanni Federico
  • Giuseppe Saggese
Research paper

Abstract

OBJECTIVE. Bone health is a major concern in patients with Turner syndrome (TS). There are few studies assessing bone mineral status in TS adolescents and none have reported a clear relationship with the risk of fracture. We assessed bone mineral status at three different skeletal sites by two different densitometric techniques in a group of TS adolescents. DESIGN. In 24 TS adolescents (17.1 ± 3.1 years) we evaluated lumbar and femoral volumetric bone mineral density (vBMD) with dual energy X-ray absorptiometry (DXA), amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) with phalangeal quantitative ultrasound (QUS). RESULTS. Mean lumbar vBMD Z-score was normal, while mean femoral vBMD, ADSoS and BTT Z-score were reduced. 8/24 (33.3%) and 13/24 (54.2%) girls had AD-SoS and BTT ≤-2 Z-score, respectively, while lumbar vBMD and femoral vBMD were ≤-2 Z-score only in 2/24 (8.4%) and 1/24 (4.2%) patients. Overall, we documented 15 fractures (three pathological) in 8 girls. Patients who reported at least one fracture had lower AD-SoS and BTT Z-score values than fracture-free girls. The presence of a value of BTT ≤-2.0 Z-score was associated with a significant OR of positive history of fracture of 11.67 (χ2 = 5.906, p =0.015, C.I. 95% 1.14–119.54). Lumbar and femoral vBMD were not related to fracture risk. CONCLUSIONS. TS adolescents may have impaired bone mineral status in skeletal sites with predominant cortical bone. Phalangeal QUS represents a useful method to identify subjects with increased fracture risk.

Key words

Bone mineral status Dual energy X-ray absorptiometry Quantitative ultrasound Turner syndrome 

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Copyright information

© Hellenic Endocrine Society 2014

Authors and Affiliations

  • Francesco Vierucci
    • 1
  • Marta Del Pistoia
    • 1
  • Paola Erba
    • 2
  • Giovanni Federico
    • 1
  • Giuseppe Saggese
    • 1
  1. 1.U.O. Pediatria Universitaria, Dipartimento Materno-InfantileAzienda Ospedaliero-Universitaria PisanaPisaItaly
  2. 2.U.O. Medicina Nucleare, Dipartimento di Scienze Oncologiche e RadiologicheAzienda Ospedaliero-Universitaria PisanaPisaItaly

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