Studies on osteoporosis X. Effect of estrogen-progestin combination on heparin-induced osteoporosis

Robin, J.C.; Ambrus, Julian L.; Ambrus, Clara M.

doi:10.1016/0039-128x(83)90130-7

Cited by 10 publications

(3 citation statements)

References 8 publications

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“…Long-term heparin therapy has been reported to cause osteoporosis in both laboratory animals and humans (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The true risk of symptomatic osteoporosis to patients treated with heparin therapy is unknown because no large studies evaluating consecutive patients, have been performed.…”

Section: Introductionmentioning

confidence: 99%

Heparin Effect on Bone Density

et al. 1990

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SummaryIn order to provide estimates of the risks of symptomatic osteoporosis and reduced bone density in premenopausal women treated with long-term (greater than 1 month) heparin therapy, we evaluated a cohort of 61 consecutive premenopausal women previously treated with long-term heparin (cases) and a group of controls matched for age, parity and duration between the last pregnancy and evaluation. All patients underwent dual photon absorptiometry of the lumbar spine and single photon absorptiometry of the wrist and most cases underwent plain lateral radiography of the thoracolumbar spine in order to exclude silent fractures. Although none of the cases suffered symptomatic fractures (0 of 61, 95% confidence intervals 0.0 to 5.9%), there was a significantly greater proportion of cases than controls with bone density below our pre-defined levels. The long-term implications of our findings are uncertain but because it is possible that the reduction in bone density predisposes women to fractures, this potential risk should be considered when treating women with long-term heparin.

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Section: Introductionmentioning

confidence: 99%

Heparin Effect on Bone Density

et al. 1990

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“…On balance, however, they suggest a beneficial effect. Some evidence indicates that progestins given alone confer protection against osteoporosis (29,83,119), and that combined estrogen/progestin regimens have a greater effect than estrogen alone by promoting new bone formation (24,25,28,93,110). There is no evidence that adding progestins to estrogens negates the beneficial effects of estrogen given alone.…”

Section: Osteoporosis and Associated Fractures: Probable Beneficial Ementioning

confidence: 99%

Benefits and risks of menopausal estrogen and/or progestin hormone use

Ernster

Bush

Huggins

et al. 1988

Preventive Medicine

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Current evidence is reviewed here on risks and benefits of estrogen and progestin use by peri- and postmenopausal women in relation to the following conditions: endometrial cancer, breast cancer, osteoporosis, and coronary artery disease (CAD). On balance, estrogen therapy appears to be beneficial for menopausal women, as it probably reduces the risks of CAD and osteoporosis, two of the major causes of mortality and morbidity. Although unopposed estrogen therapy increases the risk of endometrial cancer, that cancer is relatively rare and is not fatal in the vast majority of cases associated with estrogen use. Definitive conclusions about the relation of menopausal estrogens to breast cancer cannot be drawn due to inconsistent evidence to date. Although evidence from randomized controlled trials is lacking, biochemical and clinical evidence suggest that progestin supplementation is associated with a reduction in endometrial cancer risk in women taking menopausal estrogens. Progestin supplementation also may augment the beneficial effects of estrogens in providing protection against osteoporosis, although this effect is not yet well established. There is little direct evidence bearing on the relation of menopausal progestins to breast cancer. Although studies of CAD per se are lacking at present, progestins probably unfavorably alter lipoprotein profiles, thereby increasing a user's risk of CAD. Given the relatively high incidence and mortality of CAD in postmenopausal women, any negative effects on CAD risk could potentially counterbalance beneficial effects on other causes. We conclude that estrogen replacement therapy is of potential benefit to postmenopausal women, but that the question of progestin supplementation requires further study, particularly for CAD risk.

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“…The mechanism postulated for heparin-associated osteoporosis is not clear. Ambrus et al 15,16 have demonstrated that the administration of heparin for 3 months to female mice can lead to significant loss of body calcium.…”

Section: The Frequency Of the Event (Osteoporosis)mentioning

confidence: 99%

Nonhemorrhagic Complications of Anticoagulant Therapy

Levine¹

1986

Semin Thromb Hemost

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Studies on osteoporosis X. Effect of estrogen-progestin combination on heparin-induced osteoporosis

Cited by 10 publications

References 8 publications

Heparin Effect on Bone Density

Heparin Effect on Bone Density

Benefits and risks of menopausal estrogen and/or progestin hormone use

Nonhemorrhagic Complications of Anticoagulant Therapy

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