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Decrease of bone mineral density during estrogen substitution therapy

S Rozenberg1, R Gevers, A Peretz

  • 1Interdisciplinary Group on Osteoporosis, Free Universities of Brussels (VUB-ULB) Hôpital Saint-Pierre, Belgium.

Maturitas
|November 1, 1993
PubMed
Summary
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About 21% of postmenopausal women on hormone replacement therapy (HRT) may experience a slight decrease in bone mineral density (BMD). This study analyzed BMD changes in 102 women over two years to understand these cases.

Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Gerontology

Background:

  • Bone mineral density (BMD) changes during hormone replacement therapy (HRT) are a clinical concern.
  • Understanding the frequency and characteristics of BMD decrease in HRT patients is crucial for optimizing treatment.

Purpose of the Study:

  • To assess the frequency and characteristics of bone mineral density (BMD) changes in women undergoing hormone replacement therapy (HRT).
  • To identify factors associated with BMD decrease or gain during long-term HRT.

Main Methods:

  • Retrospective analysis of BMD data from 102 women on HRT for over 2 years with at least 3 lumbar BMD measurements.
  • Linear function fitting to BMD data over time to calculate the slope (rate of change).
  • Statistical comparison of patient groups based on BMD slope tertiles and baseline characteristics.

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Main Results:

  • Overall mean BMD showed a gain (slope of 0.007 g/cm2/year).
  • 21% of patients exhibited a negative BMD slope (decrease).
  • Significant differences in initial BMD, hydroxyproline/creatinine ratio, weight, DHEAS, and alkaline phosphatase were observed between slope groups. Patients with higher baseline bone mass were more likely to have a negative slope.

Conclusions:

  • Approximately 21% of postmenopausal women on HRT may experience a slight decrease in BMD.
  • The exact number of bone losers is difficult to determine due to measurement variability.
  • Baseline bone mass and certain biochemical markers may be associated with BMD changes during HRT.