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Maintained Bone Density in Young Hypoestrogenized Women with a High BMI: Case Series

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Abstract

Estrogen deficiency and obesity are factors that affect bone mass in a manner that is independent and in opposing directions. Obesity favours higher bone mass and increased bone formation whereas estrogen deficiency leads to significant bone loss in leaner individuals. To report the impact of the competing effects of a hypoestrogenized state and obesity on long-term bone health, we present two cases of young chronically hypoestrogenized females whose bone parameters were assessed with high-resolution peripheral quantitative computed tomography (HR-pQCT) and revealed a bone mineral density and microstructure that did not change despite the long history of a low estrogen state. As evidenced by the outcomes for these patients, the obesity-related effect on bone mass may be dominant when obesity is marked and appears to be highly protective even in the setting of sub-physiologic circulating estrogen. Recognition of this interaction should be considered in decisions around estrogen replacement therapy in such cases.

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Authors and Affiliations

  1. Department of Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada

    Anabel Cardenas Rivas & Gregory A. Kline

  2. Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada

    Lauren A. Burt & Steven K. Boyd

  3. Department of Genetics, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada

    Micheil Innes

Authors
  1. Anabel Cardenas Rivas
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  2. Lauren A. Burt
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  3. Micheil Innes
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  4. Steven K. Boyd
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  5. Gregory A. Kline
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Corresponding authors

Correspondence to Anabel Cardenas Rivas or Gregory A. Kline.

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Disclosure

Anabel Cardenas Rivas, Lauren A Burt, Micheil Innes, Steven K Boyd, Gregory A. Kline have no relevant financial or non-financial interests to disclose.

Human and Animal Rights and Informed Consent

This retrospective case series involving human participants was in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. According to the Calgary Health Research and Ethics Board, formal approval is not required for case reports provided the subjects have given written informed consent. Informed, written consent was given by both patients for publication of clinical details and imaging results.

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Rivas, A.C., Burt, L.A., Innes, M. et al. Maintained Bone Density in Young Hypoestrogenized Women with a High BMI: Case Series. Calcif Tissue Int 109, 469–473 (2021). https://doi.org/10.1007/s00223-021-00857-w

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  • DOI: https://doi.org/10.1007/s00223-021-00857-w

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