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  • Biochemical assay  (1)
  • Fractures  (1)
  • Key words: Matched case–control study – Osteoporosis  (1)
  • 1
    Digitale Medien
    Digitale Medien
    Do current regimes of hormone replacement therapy protect against subsequent fractures? (1992)
    Springer
    Osteoporosis international 2 (1992), S. 219-224 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Bone density ; Fractures ; Hormone replacement ; Oestrogens ; Progestogens
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract It is now accepted that unopposed oestrogen therapy reduces osteoporotic fractures by about 50%. Although current regimes with added progestogens are thought to act similarly to unopposed oestrogens, no study has yet demonstrated an effect on fractures with the former. Using a retrospective cohort design we studied fracture rates in women attending a menopause clinic for hormone replacement therapy (HRT) and compared them with women derived from the general population. Data were analysed from 1075 women exposed to HRT and 1741 non-exposed postmenopausal women. In all 226 fractures were reported between 1977 and 1986, the commonest site being the distal radius, occurring in 28 of the HRT women and in 37 of the non-exposed women. The incidence density rate for fracture of the distal radius is 3.5/1000 woman-years (wy) in non-exposed women. This was similar to the rate in the HRT womenprior to HRT use, the rate falling by 30% after exposure from 3.2 to 2.2/1000 wy. The protective effect on osteoporotic fractures increased progressively with duration of use. After 5 years of use the relative risk fell to 0.5 (95% confidence interval, 0.2–1.2) for all osteoporotic fractures and for the distal radius to 0.18 (95% confidence interval, 0.05–1.3). No similar changes were seen for non-osteoporotic fractures. There were 6 (0.6/1000 wy) reported fractures of the hip in the non-exposed group compared with none in the HRT group (when 1.7 were expected based on non-exposed rates) (p=0.15). Although based on observational data, this study suggests that modern HRT regimes are effective in preventing distal radius fractures and potentially other osteoporotic fractures.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01624144
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  • 2
    Digitale Medien
    Digitale Medien
    Influence of Current and Past Hormone Replacement Therapy on Bone Mineral Density: A Study of Discordant Postmenopausal Twins (1999)
    Springer
    Osteoporosis international 9 (1999), S. 158-162 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Key words: Matched case–control study – Osteoporosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: There is controversy about the ideal timing of hormone replacement therapy (HRT) and duration of treatment. In this study we have examined intrapair differences in bone mineral density (BMD) in twins who were discordant for HRT use. Twin pairs in which only one co-twin had been exposed to HRT for more than 12 months continuously were selected from 365 postmenopausal monozygotic (MZ) and dizygotic (DZ) pairs recruited as part of the St Thomas’ Adult UK Twin Registry of normal volunteers. BMD was measured by dual-energy X-ray absorptiometry at the lumbar spine and femoral neck. Intrapair differences in BMD between HRT users and non-users were compared. A total of 65 HRT-discordant pairs were identified, of which 36 were discordant for current HRT use (mean age: 55.3 years, median duration of HRT use: 36 months) and 29 were discordant for past HRT use (mean age: 60.4 years, median HRT duration: 30 months). Among current users BMD was consistently and significantly higher than in non-users at both sites (lumbar spine mean intrapair difference (IPD%): 12.3%, 95% confidence interval (CI): 7.1%, 17.5%; femoral neck IPD%: 8.6%, 95% CI: 3.4%, 13.7%). The intrapair differences were substantially smaller when past users and non-users were compared (lumbar spine IPD%: 2.4%, 95% CI: −3.7%, 8.6%; femoral neck IPD%: 0.4%, 95% CI: −5.3%, 6.0%). These differences remained little changed after adjusting for the potential confounding effects of the duration of HRT use, and intrapair differences in alcohol and tobacco consumption and physical exercise. The results confirm, in a closely matched design, the findings of other observational research that current use of HRT has a major effect on BMD at the lumbar spine and femoral neck. Past users of HRT do not, however, show the same benefits. The clinical implications of these findings are that HRT needs to be used continuously to influence BMD and that alternative treatments need to be considered in those who discontinue HRT.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001980050130
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  • 3
    Digitale Medien
    Digitale Medien
    Can biochemical markers predict bone loss at the hip and spine?: A 4-year prospective study of 141 early postmenopausal women (1996)
    Springer
    Osteoporosis international 6 (1996), S. 399-406 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Biochemical assay ; Bone densitometry ; Bone turnover ; Menopause ; Osteoporosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A number of recent studies have suggested that non-invasive measures of bone turnover are associated with bone loss at the forearm in postmenopausal women. Whether bone turnover markers are predictive of bone loss from the clinically important sites of lumbar spine and femoral neck remain unclear, and was the aim of this 4-year prospective study. One hundred and forty-one normal, postmenopausal women (mean age 52.0±3.3 years, mean menopause duration 20.4±5.7 months) were recruited for the study in 1988. Fasting early morning samples of blood and urine were collected at the baseline visit and stored at −20 °C prior to analysis. Serum was assayed for osteocalcin, oestradiol, oestrone, oestrone sulphate, testosterone, sex hormone binding globulin, dehydroepiandrosterone sulphate and total alkaline phosphatase. Urine was assayed for calcium, hydroxyproline, oestrone glucuronide and the collagen cross-links pyridinoline and deoxypyridinoline using high-performance liquid chromatography. Bone density was measured at the lumbar spine and femoral neck using dual photon absorptiometry at time 0, 12, 24 and 48 months. The mean annual percentage change in bone density (SE) was −1.41% (0.18) at the lumbar spine and −0.86% (0.22) at the femoral neck. There was no evidence of bimodality or a fast loser subgroup as the rates of change were normally distributed. Both simple and multiple stepwise regression analyses revealed no significant correlation between the rates of change in bone density with any biochemical marker, either individually or in combination, despite the study having sufficient power (80%) to detect a correlation of 0.5 between any biochemical marker levels and bone loss. We conclude that single measurements of these markers of bone turnover and endogenous sex hormones appear unlikely to be clinically useful in predicting early postmenopausal bone loss from either the spine or the hip.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01623014
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