In Turner Syndrome, Does HRT Affect Morbidity?

New study findings suggest that sex hormone replacement therapy (HRT) may have a beneficial effect on endocrine conditions, hypertension, and stroke in women with Turner syndrome (TS) and the 45,X karyotype–a population known to have an increased overall morbidity and mortality. However, no clear impact of HRT on mortality was observed in the study.

These findings shed light on the long-term effects of HRT in women with TS, which were previously unknown.

The researchers arrived at their conclusion after performing a national cohort study of all women in Denmark who had even received a diagnosis of TS between 1977 and 2014. Data were obtained from the Danish Cytogenic Central Registry, the National Patient Registry, and the Medication Statistics Registry.

A total of 1156 women whose TS was diagnosed between 1960 and 2014 were identified, along with 115,577 randomly identified, aged-matched female controls. Women with TS and matched controls were compared for mortality, hospitalizations, and medical prescriptions.

Of 329 women with 45,X karyotype, 44 had never received HRT treatment, whereas 285 had received treatment at some point in their lives. The researchers also compared mortality, hospitalizations, and medical prescriptions among HRT-treated and untreated 45,X women.

Results of the study indicated that women with TS had significantly increased endocrine and cardiovascular morbidity and mortality compared with matched controls. Similar mortality was observed among 45,X women who were HRT-treated vs untreated.

Of note, HRT-treated 45,X women had significantly lower use of antihypertensives, antidiabetics, and thyroid hormones and significantly reduced hospitalization rates for stroke and osteoporotic fractures compared with untreated 45,X women.

—Christina Vogt

Reference:
Viuff MH, Berglund A, Juul S, Andersen NH, Stochholm K, Gravholt CH. Sex hormone replacement therapy in Turner syndrome: impact on morbidity and mortality. J Clin Endocrinol Metab. 2020;105(2). https://doi.org/10.1210/clinem/dgz039.