Bone Mineral Density Assessed by Phalangeal Radiographic Absorptiometry Before and During Long-Term Growth Hormone Treatment in Girls with Turner’s Syndrome Participating in a Randomized Dose-Response Study

To assess bone mineral density (BMD) in girls with Turner’s syndrome before and during long-term treatment with GH, longitudinal measurements using phalangeal radiographic absorptiometry were per-formed in 68 girls with Turner’s syndrome. These previously untreated girls, age 2–11 y, participating in a randomized, dose-response trial, were randomly assigned to one of three GH dosage groups: group A, 4 IU/m2/d (0.045 mg/kg/d); group B, first year 4 IU/m2/d, thereafter 6 IU/m2/d (0.0675 mg/kg/d); or group C, first year 4 IU/m2/d, second year 6 IU/m2/d, thereafter 8 IU/m2/d (0.090 mg/kg/d). In the first 4 y of GH treatment, no estrogens for pubertal induction were prescribed to the girls. Thereafter, girls started with 17-estradiol (5 g/kg body weight/d, orally) when they had reached the age of 12 y. BMD results were adjusted for bone age and sex, and expressed as SD scores using reference values of healthy Dutch girls. At baseline, almost every individual BMD value of bone consisting predominantly of cortica