Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration .
Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions .
The current evidence suggests possible benefit of estrogen replacement therapy  on bone mineral density and high density lipoprotein cholesterol .
Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency .
Hence , long-term estrogen replacement therapy is the cornerstone treatment .
The estimates of its effect and optimal use , however , remain uncertain .
We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .
Nonoptimal Lipids Commonly Present in Young Adults and Coronary Calcium Later in Life: The CARDIA (Coronary Artery Risk Development in Young Adults) Study
BACKGROUND Dyslipidemia causes coronary heart disease in middle-aged and elderly adults , but the consequences of lipid exposure during young adulthood are unclear . OBJECTIVE To assess whether nonoptimal lipid levels during young adulthood cause atherosclerotic changes that persist into middle age . DESIGN Prospect i ve cohort study . SETTING 4 cities in the United States . PARTICIPANTS 3258 participants from the 5115 black and white men and women recruited at age 18 to 30 years in 1985 to 1986 for the CARDIA ( Coronary Artery Risk Development in Young Adults ) study . MEASUREMENTS  Low-density lipoprotein ( LDL ) and high-density lipoprotein ( HDL ) cholesterol , triglycerides , and coronary calcium .  Time-averaged cumulative exposures to lipids between age 20 and 35 years were estimated by using repeated serum lipid measurements over 20 years in the CARDIA study ; these measurements were then related to coronary calcium scores assessed later in life ( 45 years [ SD , 4 ] ) . RESULTS 2824 participants ( 87 % ) had nonoptimal levels of LDL cholesterol ( > or=2.59 mmol/L [ > or=100 mg/dL ] ) , HDL cholesterol ( < 1.55 mmol/L [ < 60 mg/dL ] ) , or triglycerides ( > or=1.70 mmol/L [ > or=150 mg/dL ] ) during young adulthood . Coronary calcium prevalence 2 decades later was 8 % in participants who maintained optimal LDL levels ( < 1.81 mmol/L [ < 70 mg/dL ] ) , and 44 % in participants with LDL cholesterol levels of 4.14 mmol/L ( 160 mg/dL ) or greater ( P < 0.001 ) . The association was similar across race and sex and strongly grade d , with odds ratios for coronary calcium of 1.5 ( 95 % CI , 0.7 to 3.3 ) for LDL cholesterol levels of 1.81 to 2.56 mmol/L ( 70 to 99 mg/dL ) , 2.4 ( CI , 1.1 to 5.3 ) for levels of 2.59 to 3.34 mmol/L ( 100 to 129 mg/dL ) , 3.3 ( CI , 1.3 to 7.8 ) for levels of 3.37 to 4.12 mmol/L ( 130 to 159 mg/dL ) , and 5.6 ( CI , 2.0 to 16 ) for levels of 4.14 mmol/L ( 160 mg/dL ) or greater , compared with levels less than 1.81 mmol/L ( < 70 mg/dL ) , after adjustment for lipid exposure after age 35 years and other coronary risk factors . Both LDL and HDL cholesterol levels were independently associated with coronary calcium after participants who were receiving lipid-lowering medications or had clinical ly abnormal lipid levels were excluded . LIMITATION Coronary calcium , although a strong predictor of future coronary heart disease , is not a clinical outcome . CONCLUSION Nonoptimal levels of LDL and HDL cholesterol during young adulthood are independently associated with coronary atherosclerosis 2 decades later . PRIMARY FUNDING SOURCE National Heart , Lung , and Blood Institute
Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration .
Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions .
The current evidence suggests possible benefit of estrogen replacement therapy  on bone mineral density and high density lipoprotein cholesterol .
Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency .
Hence , long-term estrogen replacement therapy is the cornerstone treatment .
The estimates of its effect and optimal use , however , remain uncertain .
We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .