Associations between Low Levels of Serum Estradiol, Bone Density, and Fractures among Elderly Women: The Study of Osteoporotic Fractures<sup>1</sup>

Ettinger, Bruce; Pressman, Alice; Sklarin, Peter M.; Bauer, Douglas C.; Cauley, Jane A.; Cummings, Steven R.

doi:10.1210/jcem.83.7.4708

Cited by 88 publications

(13 citation statements)

References 13 publications

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“…These hormonal disorders are characterized by profound hypoestrogenism with serum estradiol levels lower than 30-40 pg/ml [12]. .…”

Section: Estrogens' Influence On Bone Mineral Densitymentioning

confidence: 99%

“…The main purpose of the therapy is the achievement of appropriate serum estradiol concentration using hormonal therapy (estrogen-progestin) or using preparations which lower prolactin levels in case of hyperprolactinemia [11]. Minimal serum estradiol level which has a positive impact on bone metabolism is 40-50 pg/ml [12]. Proper diet (calcium and vitamin D 3 ) and weight gain in case of undernutrition are also very important [13].…”

Section: Introductionmentioning

confidence: 99%

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Hypoestrogenism in young women and its influence on bone mass density

Męczekalski

Podfigurna-Stopa

Genazzani

2010

Gynecological Endocrinology

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One of the most important hormonal factors responsible for bone health is estradiol. Genetic factors, adequacy of hormonal functioning, nutrition and physical activity may be the markers of bone status and development in young women. During adolescence, women reach peak bone acquisition and develop a skeletal mass. This process is largely regulated by endocrine factors mainly such as adequate levels of gonadal, adrenal and pituitary hormones. The crucial role played by estradiol and its impact on bones are very multiple. Estradiol induces growth factors' activation, receptor activator of nuclear factor kappa B ligand (RANKL) production inhibition and is mainly referred to antiresorptive activity. Clinical situations leading to hypoestrogenism has been linked to decreased bone mineral density leading to osteopenia and osteoporosis. This status both in fertile and perimenopausal women can increase the risk of pathological fractures. Such conditions as hypothalamic-pituitary insufficiency (functional hypothalamic amenorrhea, anorexia nervosa, Kallmann syndrome, hyperprolactinemia), ovarian failure (gonadal dysgenesis, premature ovarian failure) and iatrogenic treatment (surgery, chemotherapy, radiotherapy) can cause hypoestrogenism. The treatment of osteopenia and osteoporosis caused by hypoestrogenism is very essential and multidirectional. The crucial role of the therapy is the achievement of proper serum estradiol concentration and eliminate the causes of hypoestrogenism.

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“…These hormonal disorders are characterized by profound hypoestrogenism with serum estradiol levels lower than 30-40 pg/ml [12]. .…”

Section: Estrogens' Influence On Bone Mineral Densitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypoestrogenism in young women and its influence on bone mass density

Męczekalski

Podfigurna-Stopa

Genazzani

2010

Gynecological Endocrinology

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“…The serum E 2 and 25OHD levels were measured using a chemiluminescent immunoassay (CLIA) and electrochemiluminescent immunoassay, respectively, Since the serum E 2 level under the limit of detection for CLIA was < 10 pg/mL, and because this level was associated with low BMD in postmenopausal women [ 30 ], low serum E 2 levels were defined as < 10 pg/mL. Serum 25OHD levels were divided into normal (> = 30 ng/ml), insufficiency (< 30 ng/ml and > = 20 ng/ml), and deficiency (< 20 ng/ml) [ 31 ].…”

Section: Methodsmentioning

confidence: 99%

Osteoporosis in nontuberculous mycobacterial pulmonary disease: a cross-sectional study

et al. 2022

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Background Since nontuberculous mycobacterial pulmonary disease (NTM-PD) is common in middle-aged/elderly slender women at risk of osteoporosis, we hypothesized that NTM-PD could be associated with osteoporosis. The study aimed to evaluate the prevalence of osteoporosis in patients with NTM-PD compared with that in the general population and determine the factors associated with osteoporosis in the subjects, including the serum estradiol (E2) and 25-hydroxyvitamin D (25OHD) levels. Methods We have recruited 228 consecutive adult patients with NTM-PD from a prospective cohort study at the Keio University Hospital, who had no history of osteoporosis or osteoporosis-associated bone fracture but underwent dual-energy X-ray absorptiometry-based bone mineral density (BMD) evaluation from August 2017–September 2019. The E2 and 25OHD levels were measured in 165 patients with available stored serum samples. We performed multivariable logistic regression analyses for osteopenia and osteoporosis. Results Osteoporosis (T-score ≤ − 2.5) and osteopenia (T-score − 1 to − 2.5) were diagnosed in 35.1% and 36.8% of patients with NTM-PD, respectively. Compared with the general population, the proportion of osteoporosis was significantly higher in 50–59-, 60–69-, and 70–79-year-old women with NTM-PD. Multivariable analysis revealed that older age (adjusted odds ratio [aOR] for 1-year increase = 1.12; 95% confidence interval [CI] = 1.07–1.18), female sex (aOR = 36.3; 95% CI = 7.57–174), lower BMI (aOR for 1 kg/m2 decrease = 1.37; 95% CI = 1.14–1.65), and chronic Pseudomonas aeruginosa (PA) infection (aOR = 6.70; 95% CI = 1.07–41.8) were independently associated with osteoporosis. Additionally, multivariable analysis in 165 patients whose serum E2 and 25OHD levels were measured showed that both low E2 levels (< 10 pg/mL) and lower 25OHD levels were independently associated with osteoporosis. Conclusions Middle-aged/elderly women with NTM-PD have a higher prevalence of osteoporosis than the general population. BMD screening should be considered in NTM-PD, especially in older females with severe diseases such as chronic PA infection and lower BMI, and low serum E2 and 25OHD levels.

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“…Postmenopausal decline in estrogen decreases mineralization and escalates the rate of bone resorption causing osteoporosis . Apart from increasing the risk of bone fractures, estrogen deficiency also delays fracture healing. , Association of estrogen deficiency and bone health leads to the use of estrogen to treat osteoporosis in women. Systemic administration of estrogen was shown to reverse the postmenopausal decline in the BMD and reduced fragility fractures. , However, life-threatening diseases such as breast cancer, thrombosis, and stroke were associated with systemic E2 administration, and these risks depend on the dose and the length of time for E2 used.…”

Section: Introductionmentioning

confidence: 99%

Estradiol-Loaded Poly(ε-caprolactone)/Silk Fibroin Electrospun Microfibers Decrease Osteoclast Activity and Retain Osteoblast Function

Steffi

Wang

Kong

et al. 2018

ACS Appl. Mater. Interfaces

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Estrogen, a steroid hormone, plays an important role in modulating osteoclast proliferation and development. Estrogen deficiency boosts osteoclast activity, leading to osteoporosis in elderly women. In this study, 17-ß estradiol (E2)-loaded poly(ε-caprolactone) (PCL)/silk fibroin (SF) electrospun microfibers were developed as a proposed localized E2 delivery system to treat osteoporotic fractures. PCL is a synthetic polymer known for its biocompatibility and excellent mechanical properties. The bioactivity of PCL was enhanced by mixing it with a natural SF polymer that has low immunogenicity and inherent bioactivity. Different ratios of PCL/SF blends were electrospun and characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, and water contact angle measurement. PCL and SF at a ratio of 50:50 (PCL50/SF50) augmented cell proliferation of murine preosteoblast MC3T3-E1 cells and murine preosteoclast RAW 264.7 cells. Hence, PCL50/SF50 was selected and mixed with three concentrations of E2 to produce electrospun fiber mesh (0.1% E2@PCL/SF, 1% E2@PCL/SF, and 5% E2@PCL/SF). Sustained release of E2 was obtained for about 3 weeks at higher E2 concentration 5% E2@PCL/SF. An E2-loaded PCL50/SF50 elecrospun microfiber (1% E2@PCL/SF and 5% E2@PCL/SF) reduced tartrate-resistant acid phosphate activity, total DNA, and multinucleated cell formation of osteoclasts. On the other hand, the alkaline phosphatase activity and collagen I expression of osteoblasts were retained on all E2-loaded electrospun microfibers. The E2@PCL/SF system shows potential to be used for localized E2 delivery for the treatment of osteoporotic fractures.

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Associations between Low Levels of Serum Estradiol, Bone Density, and Fractures among Elderly Women: The Study of Osteoporotic Fractures¹

Cited by 88 publications

References 13 publications

Hypoestrogenism in young women and its influence on bone mass density

Hypoestrogenism in young women and its influence on bone mass density

Osteoporosis in nontuberculous mycobacterial pulmonary disease: a cross-sectional study

Estradiol-Loaded Poly(ε-caprolactone)/Silk Fibroin Electrospun Microfibers Decrease Osteoclast Activity and Retain Osteoblast Function

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Associations between Low Levels of Serum Estradiol, Bone Density, and Fractures among Elderly Women: The Study of Osteoporotic Fractures1

Cited by 88 publications

References 13 publications

Hypoestrogenism in young women and its influence on bone mass density

Hypoestrogenism in young women and its influence on bone mass density

Osteoporosis in nontuberculous mycobacterial pulmonary disease: a cross-sectional study

Estradiol-Loaded Poly(ε-caprolactone)/Silk Fibroin Electrospun Microfibers Decrease Osteoclast Activity and Retain Osteoblast Function

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Associations between Low Levels of Serum Estradiol, Bone Density, and Fractures among Elderly Women: The Study of Osteoporotic Fractures¹