Factors associated with the reduction of bone density in patients with gonadal dysgenesis

Objective: To correlate bone mineral density (BMD) in women with primary hypoestrogenism caused by 46,XX pure gonadal dysgenesis or Turner's syndrome with age, age at estrogen therapy initiation, length of estrogen use, and body mass index (BMI). Design: Cross-sectional study. Setting: Academic tertiary-care hospital. Patient(s): Thirty-eight women, aged 16 to 35 years (mean, 24.6 years), affected by these genetic disorders. Intervention(s): Measurement of lumbar spine and femoral neck BMD using double x-ray absorptiometry. The results were correlated with the control variables by using Pearson's coefficient of correlation. Variables associated with BMD were evaluated by multiple linear regression analysis. Main Outcome Measure(s): Bone mineral density. Result(s): Bone mineral density of the lumbar spine showed that 90% of the women presented osteopenia or osteoporosis. The femoral neck was affected in 55% of these women. The length of estrogen therapy and the BMI showed a positive association with BMD at the lumbar spine and femoral neck, respectively. Conclusion(s): Women affected by pure gonadal dysgenesis or Turner's syndrome presented a marked decrease in BMD of the lumbar spine and femoral neck. Medical attention for their diagnosis and early hormone replacement therapy are advised. (C) 2002 by American Society for Reproductive Medicine.