Estrogen therapy arrests bone loss in elderly women

Quigley, M. E.; Martin, Purvis L.; Burnier, Andre; Brooks, Patricia A.

doi:10.1016/0002-9378(87)90025-1

Cited by 193 publications

(36 citation statements)

References 13 publications

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“…In other words, markers decreased less in response to HRT in the older women. This would be in keeping with studies which showed that HRT does not decrease the rate of bone loss at the distal radius in women aged 71 -80 years 17 and possibly does not have as great an impact on reducing the relative risk of non-vertebral fracture in women over 60 years of age as it does in younger women 18 . However, because of the size of our study, the relationship between marker response and age should be regarded with caution.…”

Section: Baselinesupporting

confidence: 82%

The impact of subcutaneous oestradiol implants on biochemical markers of bone turnover and bone mineral density in postmenopausal women

Pereda¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To evaluate the anabolic effect of oestrogen on bone by comparing the response of markers of bone formation (and resorption) and bone mineral density (BMD) to subcutaneous oestradiol implants. Design One year double-blind placebo controlled randomised study.Setting Clinical research unit within a teaching hospital.Population Twenty-one hysterectomised postmenopausal women were randomised to 25 mg oestradiol implants at baseline and at six months or to have a sham procedure at baseline and six months. Methods BMD and quantitative ultrasound (QUS) were assessed at baseline and one year. Bone alkaline phosphatase (bone ALP), procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), free deoxypyridinoline (iFDPD), N-telopeptide of type I collagen (NTX), serum oestradiol and intact parathyroid hormone (PTH) were measured at baseline, 4, 8, 12 and 24 weeks. Main outcome measures Percentage change markers of bone turnover and PTH and change in oestradiol levels over first six months and percentage of changes in DXA and QUS over one year. Results PINP, bone ALP and OC increased by 28%, 7% and 9%, respectively ( P < 0.01) during the first four weeks of treatment and then decreased significantly. Lumbar spine (LS) and total hip (TH) BMD increased by 5.4% and 6.0% ( P < 0.001), respectively, and femoral neck (FN) BMD by 3.7% ( P < 0.05) during the first year of treatment compared with control subjects. The peak serum oestradiol level was achieved four weeks after implant insertion. Mean PTH levels increased significantly in subjects receiving subcutaneous oestradiol. Conclusion Subcutaneous oestrogen exerted an apparent anabolic effect on bone, which was initially reflected by an increase in bone formation markers and later by a large increase in BMD.

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Section: Baselinesupporting

confidence: 82%

The impact of subcutaneous oestradiol implants on biochemical markers of bone turnover and bone mineral density in postmenopausal women

Pereda¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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“…Estrogen was the most potent in reducing cholesterol levels in ovariectomized rats, whereas tamoxifen and nafoxidine were more effective than raloxifene in blocking gain in body weight. or postmenopausal women is estrogen replacement therapy, which effectively minimizes bone loss for substantial periods of time and reduces fracture occurrence in humans (1)(2)(3)(4)(5)(6)(7)(8). However, estrogens also substantially increase the incidence, but not the mortality, of endometrial cancer (9-11), with controversial effects on the incidence of breast cancer (12, 13).…”

Section: Linear Regressionmentioning

confidence: 99%

Raloxifene, tamoxifen, nafoxidine, or estrogen effects on reproductive and nonreproductive tissues in ovariectomized rats

1996

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For the first time, four well-characterized compounds from four distinct chemical classes were directly compared for efficacy and potency in hone, uteri, lipids, and adipose tissues in an ovariectomized model with 6 month old rats. Five weeks of oral dosing confirmed that ethynyl estradiol, tamoxifen, and raloxifene are potent inhibitors of the loss in volumetric bone mineral density (BMD, mg/cc) induced by ovariectomy, as measured by computed tomography. In the metaphysis of distal femora from ovariectomized rats, analysis showed a significant 12-20% decrease (P< 0.01) in the BMD. Linear regression analysis was used to calculate half-maximal efficacious doses for ethynyl estradiol ED(50) =0.04mg /kg, which was threefold more potent than tamoxifen, which in turn was threefold more potent than raloxifene, which was more efficacious than nafoxidine. In the uterus, raloxifene had minimal effects on the endometrium and smaller effects on uterine eosinophil peroxidase activity than nafoxidine, tamoxifen, or estrogen, respectively. Estrogen was the most potent in reducing cholesterol levels in ovariectomized rats, whereas tamoxifen and nafoxidine were more effective than raloxifene in blocking gain in body weight. Distinct compounds had advantages in the management of bone, uterine, serum cholesterol, and adipose tissues after ovariectomy. The distinct pattern of pharmacological effects may be best understood in terms of their respective chemical structure, specifically estrogens, benzothiophenes (raloxifene), dihydronapthylenes (nafoxidine), and triphenylethylenes (tamoxifen). These data point to advantages of separate compounds in the management of bone, uterine, serum cholesterol, and adipose tissues after estrogen deficiency, and show that the benzothiophene raloxifene has potentially important advantages over estrogen, tamoxifen, or nafoxidine in the uterus.

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“…(J Bone Miner Res 2003;18:333-342) Key words: weight, body fat mass, lean body mass, estrogen, menopause ital discomfort. (1) The positive effect of HRT on bone mineral density (BMD) (2)(3)(4)(5) and fracture rates (6 -9) has been shown in many studies. Furthermore, HRT seems to protect against loss of lean body mass (LBM), which is seen during the first 2 years after menopause.…”

mentioning

confidence: 99%

Hormone Replacement Therapy Dissociates Fat Mass and Bone Mass, and Tends to Reduce Weight Gain in Early Postmenopausal Women: A Randomized Controlled 5-Year Clinical Trial of the Danish Osteoporosis Prevention Study

Jensen

Vestergaard²,

Hermann³

et al. 2003

Journal of Bone and Mineral Research

107

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The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design. A total of 2016 women ages 45-58 years from 3 months to 2 years past last menstrual bleeding were included. One thousand were randomly assigned to HRT or no HRT in an open trial, whereas the others were allocated according to their preferences. All were followed for 5 years for body weight, bone mass, and body composition measurements. Body weight increased less over the 5 years in women randomized to HRT (1.94 ؎ 4.86 kg) than in women randomized to no HRT (2.57 ؎ 4.63, p ‫؍‬ 0.046). A similar pattern was seen in the group receiving HRT or not by their own choice. The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat. The main determinant of the weight gain was a decline in physical fitness. Women opting for HRT had a significantly lower body weight at inclusion than the other participants, but the results in the self-selected part of the study followed the pattern found in the randomized part. The change in fat mass was the strongest predictor of bone changes in untreated women, whereas the change in lean body mass was the strongest predictor when HRT was given. Body weight increases after the menopause. The gain in weight is related to a decrease in working capacity. HRT is associated with a smaller increase in fat mass after menopause. Fat gain protects against bone loss in untreated women but not in HRT-treated women. The data suggest that women's attitudes to HRT are more positive if they have low body weight, but there is no evidence that the conclusions in this study are skewed by selection bias. (J Bone Miner Res 2003;18:333-342)

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Estrogen therapy arrests bone loss in elderly women

Cited by 193 publications

References 13 publications

The impact of subcutaneous oestradiol implants on biochemical markers of bone turnover and bone mineral density in postmenopausal women

The impact of subcutaneous oestradiol implants on biochemical markers of bone turnover and bone mineral density in postmenopausal women

Raloxifene, tamoxifen, nafoxidine, or estrogen effects on reproductive and nonreproductive tissues in ovariectomized rats

Hormone Replacement Therapy Dissociates Fat Mass and Bone Mass, and Tends to Reduce Weight Gain in Early Postmenopausal Women: A Randomized Controlled 5-Year Clinical Trial of the Danish Osteoporosis Prevention Study

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