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  • 1
    Electronic Resource
    Electronic Resource
    Magnitude and pattern of skeletal response to long term continuous and cyclic sequential oestrogen/progestin treatment (1994)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate the magnitude and pattern of the changes in bone mass during five years of continuous and cyclic sequential oestrogen/progestin treatment.Design Prospective study of normal, early postmenopausal women, initially a double-blind, placebo controlled trial, subsequently an open, controlled investigation.Setting Clinical physiology unit of a general hospital.Subjects Sixty-eight normal, early postmenopausal women.Results 1. Continuous treatment resulted in significantly higher lumbar spine bone density than did sequential treatment (P 〈 0.001). Lumbar spine bone density was 19% and 15%, respectively, above that of untreated women after three years and onwards, and 10% and 6%, respectively, above the initial value; 2. Both regimens induced a more pronounced rise in lumbar spine bone density than in forearm bone mineral content (P 〈 0.001); 3. The spontaneous decline (without treatment) in lumbar spine bone density and forearm bone mineral content averaged 1.86% and 1.90% per year, respectively. 4. There was a significant bone loss from the lumbar spine during the last year of active treatment (P 〈 0.001). This would suggest that lumbar spine bone density rises to a certain level and subsequently declines. However, neither data pooled before computation nor data processed individually for each patient over five years allowed for any definite conclusions regarding the pattern of the long term skeletal response to combined oestrogen/progestin treatment.Conclusion Five years treatment with oestradiol/norethisterone resulted in a substantial gain in bone mass. The highest values were found in the axial skeleton with daily administration of 2 mg oestradiol and 1 mg norethisterone. It is likely that bone mass after an absolute rise begins to decline after about four years of treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1994.tb13618.x
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  • 2
    Electronic Resource
    Electronic Resource
    Interpretation of lumbar spine densitometry in women with fractures (1993)
    Springer
    Osteoporosis international 3 (1993), S. 276-282 
    Details
    ISSN: 1433-2965
    Keywords: Bone mineral content ; Bone mineral density ; Fracture risk ; Osteodensitometry ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Identification of postmenopausal women at risk of developing osteoporotic fractures is a major clinical problem. In this study the use of projected planar lumbar bone density values for individual fracture risk assessment was questioned. Osteodensitometry (DXA) results from 415 normal women, 62 women with previous vertebral compressions, and 76 women with previous low-energy fractures were analyzed, together with their body size and lumbar vertebral body size variables. The following were found: (1) Lumbar vertebral projected bone mineral areal density (BMD) and bone mineral content (BMC) of normal women correlated with body size variables (p〈0.001). (2) Lumbar vertebral body size variables also correlated with body size variables (p〈0.001). Logistic regression analysis of measured and derived physical variables from women without and with vertebral compression fractures (n=477) showed: (3) The best compression fracture discriminator, significantly better than BMD, was BMC divided by (Hmax/165 cm)15×(D/4.35 cm)1.5, where Hmax is the body height (cm) at the menopause, and D the mean lumbar vertebral diameter of the three mid-lumbar vertebral bodies (cm). This parameter was termed BMCcorr.. ROC analysis showed: (4) At a BMCcoor. true positive ratio of 80% the corresponding uncorrected BMC or BMD true positive ratio was only 60%. The corresponding false positive ratio was 6%. Lumbar osteodensitometry could not be used to identify women with a history of peripheral low-energy fractures. (5) BMCcoor. did not, unlike BMC and BMD, correlate with body size and vertebral size variables. (6) Likewise, an observed correlation between BMC and lean body mass in a subpopulation of 116 normal women was abolished when BMCcorr. replaced BMC. We suggest that vertebral compression fracture risk limits based on BMC, corrected for individual differences in body size and vertebral body size, replace the commonly used BMD fracture risk limits. The discriminatory ability of BMCcorr. for low-energy fractures needs to be tested in a different population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623833
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    Paper (German National Licenses)
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