The Short-Term Effects of Conjugated Estrogen on Bone Turnover in Older Women

Prestwood, Karen M.; Pilbeam, Carol C.; Burleson, Joseph A.; Woodiel, Florence N.; Delmas, Pierre D.; Deftos, Leonard J.; Raisz, Lawrence G.

doi:10.1097/00006254-199503000-00024

Cited by 19 publications

(25 citation statements)

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“…A close correlation is observed among the various markers of bone resorption, especially between pyridinoline and deoxypyridinoline and between pyridinoline and free cross links (61). Of particular interest is the present observation of a marked increase in the concentration of serum osteocalcin, a well recognized marker of bone formation.…”

Section: Discussionsupporting

confidence: 61%

“…Treatment with estrogens is known to decrease the value of the markers of bone resorption, namely urinary hydroxyproline, total and free pyridinoline and deoxypyridinoline cross-links, and N-telopeptides of type I collagen as well as serum C-terminal cross-linked collagen telopeptide (61). A close correlation is observed among the various markers of bone resorption, especially between pyridinoline and deoxypyridinoline and between pyridinoline and free cross links (61).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of 12-Month Dehydroepiandrosterone Replacement Therapy on Bone, Vagina, and Endometrium in Postmenopausal Women

Labrie

Diamond

Cusan

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

195

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The effect of 12-month dehydroepiandrosterone (DHEA) replacement therapy has been evaluated in 14 60- to 70-yr-old women who received daily applications of a 10% DHEA cream. Vaginal epithelium maturation was stimulated by DHEA administration in 8 of 10 women who had a maturation value of zero at the onset of therapy, whereas a stimulatory effect was also seen in all three women who had an intermediate vaginal maturation index before therapy. The estrogenic effect of DHEA observed in the vagina was not observed in the endometrium, which remained atrophic in all women. Most interesting, the bone mineral density significantly increased at the hip from 0.744 +/- 0.021 to 0.759 +/- 0.025 g/cm2 after 12 months of treatment (P < 0.05). These changes in bone mineral density were associated with a significant 20.0% decrease (P < 0.01) in plasma bone alkaline phosphatase and a 28% decrease in the urinary hydroxyproline/creatinine ratio. A 2.1-fold increase over the control value (P < 0.01) in plasma osteocalcin was concomitantly observed. The present data describe for the first time a series of medically important beneficial effects of DHEA therapy in postmenopausal women through transformation of the precursor steroid DHEA into androgens and/or estrogens in specific peripheral intracrine tissues without significant adverse effects. The stimulatory effect on the vaginal epithelium in the absence of stimulation of the endometrium is of particular interest because it eliminates the need for progestin replacement therapy. On the other hand, the stimulatory effect on bone mineral density accompanied by an increase in serum osteocalcin, a marker of bone formation, suggests stimulation of bone formation by the androgenic action of DHEA, a finding of particular interest for both the prevention and treatment of osteoporosis.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Effect of 12-Month Dehydroepiandrosterone Replacement Therapy on Bone, Vagina, and Endometrium in Postmenopausal Women

Labrie

Diamond

Cusan

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

195

View full text Add to dashboard Cite

show abstract

“…In fact, human studies have been disappointing. For example, serum ICTP decreased in patients on estrogen replacement therapy (ERT) but did not return to baseline after ERT as did other markers of bone resorption, suggesting that it is not as sensitive as the other assays [30]. Measurement of hydroxyproline in the urine has been widely used for many years.…”

Section: Other Markers Of Bone Resorptionmentioning

confidence: 99%

Bone turnover markers: understanding their value in clinical trials and clinical practice

2009

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While bone mineral density (BMD) by dual-energy X-ray absorptiometry is the primary method of determining fracture risk, assessing bone turnover may add valuable information for the management of patients with low bone mass. Bone turnover markers (BTMs) are used in clinical trials where they can provide essential information on the biological efficacy of osteoporosis treatments. In such population-based studies, BTMs can predict fracture risk independent of BMD. When combined with BMD, they improve the fracture risk estimate above and beyond BMD alone in postmenopausal osteoporotic women. Since changes in bone turnover after the initiation of therapy with bone resorption inhibitors occur much more rapidly than changes in BMD, treatment efficacy could, in theory, be determined within weeks of using BTMs. However, such predictive value is limited by the large biological variability of these biochemical markers, even though newer automated methods have reduced their analytical variability. Consequently, widespread adoption as a means of predicting treatment efficacy in fracture prevention for individual patients cannot yet be recommended. BTMs may be useful for monitoring adherence to antiresorptive therapy and may aid in identifying patients for whom antiresorptive therapy is most appropriate. Thus, although BTMs are currently confined to clinical research applications, further improvement in assay precision may extend their diagnostic value in clinical settings.

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“…The increased rate of remodelling on the bone surfaces is reflected by increased serum levels of markers of resorption and formation (Hansen et al 1991, Uebelhart et al 1991. Treatment with antiresorptive agents such as hormone therapy after menopause (Uebelhart et al 1991, Prestwood et al 1994 or bisphosphonates (Garnero et al 1994) suppresses bone resorption whereas treatment with anabolic agents such as parathyroid hormone stimulates bone formation (Reeve et al 1980). In rat models, inactivation of the sympathetic nervous system impairs bone resorption (Cherruau et al 1999) and increases bone formation (Minkowitz et al 1991).…”

Section: Discussionmentioning

confidence: 99%