Bone mineral density and sex hormone status in intellectually disabled women on progestin‐induced amenorrhea

Arvio, Maria; Kilpinen-Loisa, Päivi; Tiitinen, Aila; Huovinen, K.; Mäkitie, Outi

doi:10.1080/00016340902763244

Cited by 14 publications

(18 citation statements)

References 29 publications

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“…The endpoint of this age model represents the beginning of degenerative changes with the complete obliteration of vertebral fusion lines and closed superior sacral segments (Roksandic & Armstrong, ). Women, elderly individuals, adolescents, and children were excluded from the functional sample in order to avoid sex, age, and hormonal influence as confounders (Arvio, Kilpinen‐Loisa, Tiitinen, Huovinen, & MÄKitie, O., ; More, Bhattoa, Bettembuk, & Balogh, ; Peichl et al, ; Villotte & Knusel, ). Additionally, we excluded individuals with macroscopically visible traces of pathological conditions that could interfere with the results.…”

Section: Methodsmentioning

confidence: 99%

A microarchitectural assessment of the gluteal tuberosity suggests two possible patterns in entheseal changes

Djukić

Milovanović

Milenković

et al. 2020

American J Phys Anthropol

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Objectives: Macroscopic entheseal forms show two main features: predominant signs of bony formation or resorption. To understand the development of these forms, we investigated microarchitectural differences between the macroscopic proliferative and resorptive forms of the gluteus maximus enthesis. Materials and Methods:The macromorphological analysis of entheseal changes (EC) was based on the Villotte, visual scoring system for fibrous entheses. Gluteal tuberosity specimens of different stages of Villote's system were harvested from 16 adult males derived from an archaeological context and scanned using microcomputed tomography.Results: The microarchitectural analyzes of cortical bone demonstrated a trend of higher porosity in the resorptive compared to the proliferative phase in Stage B, whereas a 30% porosity reduction was detected in the resorptive compared to proliferative phase of Stage C. In terms of the trabecular bone between the resorptive and proliferative entheseal phases, there was a trend of increased connectivity density,

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Section: Methodsmentioning

confidence: 99%

A microarchitectural assessment of the gluteal tuberosity suggests two possible patterns in entheseal changes

Djukić

Milovanović

Milenković

et al. 2020

American J Phys Anthropol

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“…Risk factors for compromised bone health include reduced mobility, hypogonadism and use of anti‐epileptic drugs (Jaffe et al. 2005; Arvio et al. 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have estimated fractures to occur 1.7 to four times more frequently in people with ID than in normal population (Tannenbaum et al 1989;Lohiya et al 1999;Downs et al 2008). Risk factors for compromised bone health include reduced mobility, hypogonadism and use of anti-epileptic drugs ( Jaffe et al 2005;Arvio et al 2009). In addition, adults with ID are at risk of vitamin D insufficiency because of lack of sunshine exposure, especially if institutionalized, and because of feeding difficulties and consequent nutritional deficiencies (Vanlint & Nugent 2006).…”

Section: Introductionmentioning

confidence: 99%

Vitamin D status and optimal supplementation in institutionalized adults with intellectual disability

Kilpinen-Loisa

Arvio

Ilvesmäki

et al. 2009

J intellect Disabil Res

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Vitamin D insufficiency was common in adults with ID living in nursing homes. Both oral and intramuscular administrations of vitamin D3 improved vitamin D status without adverse effects. The treatment response at 6 months was better in the PO group. High-dose intramuscular vitamin D3 injections may be a convenient way to maintain sufficient vitamin D status in adults with ID but further studies are needed to establish the optimal dose and interval as well as subsequent potential health benefits in these patients. Based on this study, vitamin D supplementation with per oral 800 IU/day is recommended to all adults with ID living in nursing homes.

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“…Intramuscular injection every 12 weeks is usually sufficient. However, its mode of action is not only by inducing endometrial atrophy but also by switching off the hypothalamic pituitary ovarian axis with resultant hypoestrogenism [36,37]. In both a normal girl and specifically a girl with a disability and immobility with precarious bone health, this can have major additive adverse effects on bone accrual and maintenance.…”

Section: Pubertal Problemsmentioning

confidence: 99%

Endocrine Problems in Children and Adolescents Who Have Disabilities

Zacharin

2013

Horm Res Paediatr

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The consequences of disability span almost all aspects of life, for families and for an affected individual. Endocrine aspects of disability cover disorders of hypothalamic pituitary dysfunction, bone health, puberty, fertility, sexual function and contraceptive needs. Adequate endocrine assessment for a child with a disability requires extensive and sensitive history to address social issues, general nutrition, vitamin D status, specific hypothalamic pituitary problems, together with parental concerns regarding puberty and contraception. Bone health assessment includes history of minimal trauma fracture, need for intervention or fitness for surgery. Strategic interventions to improve outcome include management of puberty, vitamin D status, biomechanical stimulation with vibration and standing and possible consideration for bisphosphonate in special circumstances. Both early and late puberty cause major family concerns. The paediatrician must be aware of a range of management options to improve outcomes for the child and family.

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Bone mineral density and sex hormone status in intellectually disabled women on progestin‐induced amenorrhea

Abstract: Osteoporosis with concomitant fractures is prevalent in women with intellectual disability on therapeutic amenorrhea. Progestin-induced amenorrhea results in hypogonadism, an established risk factor for osteoporosis. New strategies for the management of menstruation should be considered.

Cited by 14 publications

References 29 publications

A microarchitectural assessment of the gluteal tuberosity suggests two possible patterns in entheseal changes

A microarchitectural assessment of the gluteal tuberosity suggests two possible patterns in entheseal changes

Vitamin D status and optimal supplementation in institutionalized adults with intellectual disability

Endocrine Problems in Children and Adolescents Who Have Disabilities

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