Factors in response to treatment of early postmenopausal bone loss
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Bone mineral content (BMC) was measured by125I photon absorptiometry every 3 months in 264 normal females (45–54 years) over a 2-year period together with serum samples for calcium, phosphate, magnesium, creatinine, alkaline phosphatases, potassium, and protein. A 48-h urinary calcium and creatinine measurement was obtained. The subjects were divided into 7 treatment groups and 3 placebo groups. Five of the treatments (thiazide, vitamin D3, fluoride + vitamin D3, fluoride, and 1αD3) were ineffective at the doses used; the annual loss of compact bone was 1.5–2.2% (-X=1.8%), similar to the loss seen with placebos. Estrogen and estrogen + thiazide, in contrast, produced a 1.34% annual increase of BMC.
The subjects were divided into groups with low, medium, and high initial BMC. Also, individual regressions for bone change were calculated and the subjects were divided into groups of responders, maintainers, and losers (annual change of >0%, 0 to −1%, and >−1%, respectively).
The initial BMC status did not consistently affect bone or biochemical responses to the therapeutic agents. Estrogen was effective even in subjects with high BMC, whereas the other agents did not inhibit bone loss even in subjects with low initial BMC. Virtually all subjects responded to estrogen positively; in contrast we could not identify a subset of “responders” with any of the other treatments. Time since menopause appeared to influence the bone changes, although it was not a significant effect given the sample size. Bone loss in groups not treated with estrogens was 2%/year at 20 months after menopause with a decline to 1.3%/year at 45 months post-menopause. There was no apparent decline in the bone response to estrogen during the first 4 years after menopause, and in fact bone response tended to increase with time.
Key wordsOsteoporosis Vitamin D Bone mineral Estrogen Aging Thiazide Fluoride Calcium
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- 1.Mazess, R. B., Cameron, J. R.: Bone mineral content in normal U.S. whites. In R. B. Mazess (ed.): International Conference on Bone Mineral Measurement, pp. 228–238. DHEW Publ., Washington D.C., 1974Google Scholar
- 4.Meema, H. E., Meema, S.: Compact bone mineral density of the normal human radius, Acta Radiol. Oncol.17:342–352, 1978Google Scholar
- 6.Dequeker, J.: Bone Loss in Normal and Pathological Conditions. Leuven University Press, Leuven, Belgium, 1972Google Scholar
- 11.Mazess, R. B., Christiansen, C.: A comparison of BMC results from Denmark and the U.S., Scand. J. Clin. Lab. Invest. (submitted)Google Scholar
- 17.Saville, P. D.: Observations on 80 women with osteoporotic spine fractures. In U.S. Barzel (ed.): Osteoporosis, pp. 38–45. Grune & Stratton, New York, 1970Google Scholar
- 19.Nordin, B. E. C.: Metabolic Bone and Stone Disease. Williams & Wilkins Co., Baltimore, 1973Google Scholar
- 22.Frost, H. M.: Bone Remodeling and Its Relationship to Metabolic Bone Disease. Charles C. Thomas, Springfield, Ill., 1973Google Scholar
- 25.Meunier, P. J., Bressot, C., Vignon, E., Edouard, C., Alexandre, C., Courpron, P., Laurent, J.: Radiological and histological evaluation of post-menopausal osteoporosis treated with sodium fluoride-vitamin D-calcium. Preliminary results, In B. Courvaisier, A. Donath, C. A. Baud (eds.): Fluoride and Bone, pp. 263–276. Hans Huber Publ., Bern, 1978Google Scholar
- 26.Ringe, J. D., Kruse, H. P., Kuhlencordt, F.: Long term treatment of primary osteoporosis by sodium fluoride. In B. Courvaisier, A. Donath, C. A. Baud (eds.): Fluoride and Bone, pp. 228–232. Hans Huber Publ., Bern, 1978Google Scholar
- 27.Crilly, R. G., Horsman, A., Marshall, D. H., Nordin, B. E. C.: Postmenopausal and corticosteroid-induced osteoporosis, Front. Horm. Res.5:53–75, 1978Google Scholar
- 30.Nachtigall, L. E., Nachtigall, R. H., Nachtigall, R. D., Beckman, E. M.: Estrogen replacement therapy. I. A 10-year prospective study in the relationship to osteoporosis, J. Am. Col. Obstet. Gynecol.53:277–281, 1979Google Scholar