Endocrine Abstracts

JOINT850

Background: Primary Ovarian Insufficiency (POI) is associated with osteoporosis and an increased risk of fractures. However, scarce data exists on the trabecular bone score (TBS) in adolescents with POI. We aimed to evaluate bone mineral density (BMD) and TBS in adolescents and young adults with POI.

Methods: This retrospective study included girls aged 10–24 years with POI who underwent at least one dual-energy X-ray absorptiometry (DXA) scan at our institution between 2020 and 2025. POI was defined as irregular menses and follicle-stimulating hormone (FSH) levels >20 IU/lon two occasions at least one month apart. Clinical data, including hormonal levels and POI etiology, were extracted from medical records. Measurements were compared between girls with Turner syndrome (TS) and those without Turner syndrome (non-TS).

Results: Twenty-four girls underwent DXA scans at a mean age of 17.7±2.2 years (range 15.3–21.7). POI was diagnosed at a mean age of 14.8±3.3 years, earlier in TS (11.7±2.6) than in non-TS girls (16.4±2.5). The mean FSH level at diagnosis was 75.3±41.4 IU/l, lower in TS (48.3±23.2) than in non-TS girls (88.7 ± 42.5, p=0.01). Most girls presented with amenorrhea (96%, n=23): among them, 52% (n=12) had primary amenorrhea, 48% (n=11) had secondary amenorrhea, and one was diagnosed through fertility counselling. The mean L1-L4 bone mineral density (BMD) Z-score was -1.55±1.24, the total body less skull BMD Z-score was -0.62±0.92, and the L1-L4 TBS Z-score was -0.87±0.78. In three patients with repeated DXA scans, TBS Z-scores increased from 1.37±0.13 to 1.44±0.07 after an average of 1.7±0.7 years of hormone replacement therapy (HRT). TS girls had higher mean L1-L4 BMD Z-scores (-0.26±1.25 vs. -2.08±0.76, p=0.007), total body less skull BMD Z-scores (0.12±0.56 vs. -0.90±0.75, p=0.01), and TBS Z-scores (-0.17±0.91 vs. -1.15±0.51, p=0.03) compared to non-TS girls. TS girls also had a longer duration of HRT before DXA (3.10±3.34 vs. 0.38±1.42 years, p=0.07). The mean age at DXA was similar between TS (17.89±2.75) and non-TS girls (17.61±1.91).

Conclusions: Girls with POI exhibited low L1-L4 BMD and TBS Z-scores, which improved with HRT. TS girls had significantly better bone health metrics than non-TS girls, potentially due to a longer duration of HRT. These findings underscore the critical need for early diagnosis and intervention to optimize bone health in this population.