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Bone mineral density in lymphangioleiomyomatosis
Angelo M Taveira-Dasilva1, Mario P Stylianou, Carolyn J Hedin
1Pulmonary-Critical Care Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10, Room 6D05, MSC 1590, Bethesda, MD 20892-1590, USA. dasilvaa@nhlbi.nih.gov
American Journal of Respiratory and Critical Care Medicine
|October 7, 2004
Summary
Bone mineral density (BMD) loss is common in Lymphangioleiomyomatosis (LAM). While progesterone therapy did not affect BMD, bisphosphonates helped reduce bone loss in LAM patients.
Area of Science:
- Endocrinology
- Pulmonology
- Bone Metabolism
Background:
- Estrogen deficiency and pulmonary diseases are linked to bone mineral density (BMD) loss.
- Lymphangioleiomyomatosis (LAM) is a rare lung disease in women often treated with antiestrogen therapies.
- The impact of antiestrogen therapy on BMD in LAM patients and the efficacy of bisphosphonates require investigation.
Purpose of the Study:
- To determine the prevalence of BMD abnormalities in LAM patients.
- To assess if antiestrogen therapy (progesterone, oophorectomy) affects BMD.
- To evaluate if bisphosphonate treatment prevents bone loss in LAM.
Main Methods:
- Yearly BMD evaluation in 211 LAM patients.
- Analysis of BMD changes in relation to lung disease severity, age, menopause, oophorectomy, progesterone, and bisphosphonate treatment.
- Statistical adjustments for initial lung function and BMD.
Main Results:
- Abnormal BMD was prevalent in 70% of LAM patients, correlating with lung disease severity and age.
- Progesterone therapy showed no significant difference in BMD decline compared to untreated patients.
- Bisphosphonate treatment was associated with significantly lower rates of lumbar spine BMD and T-score decline compared to no treatment.
Conclusions:
- Abnormal BMD is frequent in patients with LAM.
- Progesterone therapy does not appear to negatively impact BMD in LAM.
- Bisphosphonates are associated with reduced bone loss and are recommended for systematic evaluation and early treatment in LAM patients.