This paper is only available as a PDF. To read, Please Download here.
Abstract
A decrease in bone mineral density (BMD) in patients treated with hormone replacement
therapy (HRT) is sometimes observed in clinical practice. In order to assess the frequency
and the characteristics of these cases, we reviewed the data of 102 women treated
with HRT for more than 2 years, and who had undergone at least 3 lumbar BMD measurements
during that period. For each patient, a linear function was fitted to the BMD data
in relation to time. The slope was calculated. There was an overall gain in BMD during
treatment, mean (± S.E.M.) values of slope 0.007 g/cm2/year (± 0.002). Fifty-three patients had a slope higher than 0.005, 28 a slope close
to 0 (between 0.005 and −0.005) and 21 a slope lower than −0.005. By dividing the
patients in tertiles of slopes (tertile l: slope < 0; tertile II: 0 < slope < 0.011;
tertile III: slope > 0.011), significant differences were observed between the three
groups of slope for the initial BMD (P < 0.001), hydroxyproline/creatinine ratio (P < 0.01), weight, DHEAS and alkaline phosphatase (P < 0.05). Only 1 of the 15 patients with a low bone mass (lower than mean ± I S.D.)
had a negative slope, while 9 of the 16 with a high-bone mass (higher than mean ±
I S.D.), had a negative slope. Under HRT, about 21% of postmenopausal women have a
slight decrease in BMD as assessed by DPA. Because of the DPA coefficient of variation,
however, the exact number of bone losers cannot be determined. Nevertheless, the present
study suggests that patients with low bone mass are likely to respond better than
patients with high bone mass.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- NIH consensus conference. J Am Med Assoc. 252. 1984: 799-802
- Overview of prevention strategies in osteoporosis.in: Christiansen C. Overgaard K Third International Symposium on Osteoporosis, Copenhagen, Denmark1990: 945-947
- Long-term prevention of postmenopausal osteoporosis by oestrogen.Lancet. 1976; i: 1038-1040
- Bone mass in postmenopausal women after withdrawal of oestrogen/gestagen replacement therapy.Lancet. 1981; i: 459-461
- Effects of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in postmenopausal women.Lancet. 1990; ii: 265-269
- Effects of one-year treatment with estrogens on bone mass, intestinal calcium absorption, and 25-hydroxyvitamin D-1 alphahydroxylase reserve in postmenopausal osteoporosis.Calcif Tissue Int. 1988; 42: 77-86
- Effect of estrone sulfate on postmenopausal bone loss.Obstet Gynecol. 1990; 76: 579-584
- 17β-Estradiol and continuous noresthirone: a unique treatment for established osteoporosis in elderly women.J Clin Endocrinol Metab. 1990; 71: 836-841
- Preventive effects on postmenopausal bone loss of percutaneous 17β-estradiol in early and late menopause in Osteoporosis.in: Christiansen C Overgaard K Third International Symposium on Osteoporosis, Copenhagen, Denmark1990: 1910-1916
- Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy.Ann Intern Med. 1982; 97: 699-705
- The minimum effective dose of estrogen for prevention of postmenopausal bone loss.Obstet Gynecol. 1984; 63: 759-763
- The effect of percutaneous estradiol and natural progesterone on postmenopausal bone loss.Am J Obstet Gynecol. 1987; 156: 61-65
Article info
Publication history
Accepted:
February 9,
1993
Received in revised form:
February 8,
1993
Received:
October 30,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
