Progesterone and bone: a closer link than previously realized

Seifert-Klauss, Vanadin; Schmidmayr, Monika; Hobmaier, E.; Wimmer, T.

doi:10.3109/13697137.2012.669530

Cited by 24 publications

(14 citation statements)

References 8 publications

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“…Blastic lesions occur due to additional osteoblasts filling the bone, while lytic lesions destroy the native bone. Recent in vitro studies have documented progesterone’s ability to promote osteoblast maturation and differentiation and therefore increase osteoblast numbers [23]. Additionally, prior studies have often focused on estrogen’s contribution in prevention of bone loss [19].…”

Section: Discussionmentioning

confidence: 99%

Influence of Hormone Receptor Status on Spinal Metastatic Lesions in Patients with Breast Cancer

Goldstein¹,

Nesbit²,

Chen³

2016

World Neurosurgery

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Bony metastasis predominantly affects the spinal column and has been commonly associated with breast cancer patients. There are two types of lesions that can occur with spine cancer, osteolytic or osteoblastic. Some patients may have mixed lesions, which include lytic and blastic in one vertebra or lytic and blastic in different vertebrae. Previous studies have shown breast cancer patients have an increased likelihood for development of lytic spinal metastases. A retrospective chart review was conducted to more closely examine the association between hormone receptor status and spinal lesion type. 195 patients were initially identified through the City of Hope Cancer Registry. Out of the 195, only 153 patients had hormone receptor marker status available. Associations between spinal lesion and hormone receptor status were evaluated using Chi-Square tests with alpha =.05 significance level. In a secondary analysis, the Oncomine Platform ® was used, which integrated The Cancer Genome Atlas (TCGA) datasets, to identify osteogenic genes that may be relevant to invasive breast cancers. Contrary to previous studies, our findings revealed progesterone receptor positive (PR+) patients were significantly more likely to present with blastic than lytic or mixed lesions. Furthermore using TCGA analysis, COL1A1 and COL1A2 were found to be upregulated, which could provide a molecular explanation for the development of blastic metastases. By integrating both clinical and bioinformatic techniques, this study provides a novel discovery of the relationship between blastic and PR+ breast cancers, which may have important implications for diagnostic strategies concerning vertebral metastases.

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Section: Discussionmentioning

confidence: 99%

Influence of Hormone Receptor Status on Spinal Metastatic Lesions in Patients with Breast Cancer

Goldstein¹,

Nesbit²,

Chen³

2016

World Neurosurgery

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“…Perimenopausal spinal BMD loss rates exceed those in early menopause (À1.83 ± 4.49% vs. À1.22 ± 3.14%; p ¼ 0.005) 26,32 , as confirmed in prospective, population data 32 . Given that perimenopausal E2 levels are significantly higher 26 , high bone resorption must relate to repeatedly declining E2 levels 25 plus disturbed ovulation 28 and decreased bone formation 33 (Box 2) 26,32,34 .…”

Section: Perimenopausementioning

confidence: 99%

Progesterone for the prevention and treatment of osteoporosis in women

Prior

2018

Climacteric

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Estradiol (E2) is women's dominant 'bone hormone' since it is essential for development of adolescent peak bone mineral density (BMD) and physiological levels prevent the rapid (3-week) bone resorption that causes most adult BMD loss. However, deceasing E2 levels trigger bone resorption/loss. Progesterone (P4) is E2's physiological partner, collaborating with E2 in every cell/tissue; its bone 'job' is to increase P4-receptor-mediated, slow (3-4 months) osteoblastic new bone formation. When menstrual cycles are normal length and normally ovulatory, E2 and P4 are balanced and BMD is stable. However, clinically normal cycles commonly have ovulatory disturbances (anovulation, short luteal phases) and low P4 levels; these are more frequent in teen and perimenopausal women and increased by everyday stressors: energy insufficiency, emotional/social/economic threats and illness. Meta-analysis shows that almost 1%/year spinal BMD loss occurs in those with greater than median (∼31%) of ovulatory disturbed cycles. Prevention of osteoporosis and fragility fractures requires the reversal of stressors, detection and treatment of teen-to-perimenopausal recurrent cycle/ovulatory disturbances with cyclic oral micronized progesterone. Low 'Peak Perimenopausal BMD' is likely the primary risk for fragility fractures in later life. Progesterone plus estradiol or other antiresorptive therapies adds 0.68%/year and may be a highly effective osteoporosis treatment. Randomized controlled trials are still needed to confirm progesterone's important role in women's bone formation.

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“…Peak bone mass occurs around 19 years in women and 20.5 years in men 33. Oestrogen increases uptake of calcium into blood and deposition into bone, while progesterone facilitates the actions of oestrogen through multiple complex mechanisms 34. Even silent oestrogen/progesterone imbalance, as seen in subclinical ovulatory disturbances with low EA may produce negative changes in bone 35.…”

Section: Introductionmentioning

confidence: 99%

The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)

et al. 2014

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Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations.

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Progesterone and bone: a closer link than previously realized

Cited by 24 publications

References 8 publications

Influence of Hormone Receptor Status on Spinal Metastatic Lesions in Patients with Breast Cancer

Influence of Hormone Receptor Status on Spinal Metastatic Lesions in Patients with Breast Cancer

Progesterone for the prevention and treatment of osteoporosis in women

The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)

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