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Monitoring estrogen replacement therapy and identifying rapid bone losers with an immunoassay for deoxypyridinoline

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Abstract

We have assessed urinary deoxypyridinoline (Dpd) levels by immunoassay in women who participated in a double-masked, placebo-controlled trial of the bone loss prevention effects of estrogen replacement therapy (ERT). Ninety-one women who had undergone recent surgical menopause were randomdized to receive either placebo or 0.025, 0.05 or 0.1 mg/day transdermal 17β-estradiol for 2 years. Mean Dpd levels in the postmenopausal women were significantly elevated (p<0.0001) above mean Dpd levels in a reference population of healthy, premenopausal women. Subjects in the placebo group lost 6.4% of lumbar spine bone mineral density (BMD) and 4.9% of mid-radius bone mineral content (BMC) over 2 years. Dpd levels at baseline were inversely correlated with BMD and BMC changes in the placebo group. The placebo group and subjects receiving 0.025 mg/day 17β-estradiol who had Dpd levels increased above the reference interval cut-off (mean + 2 standard deviations, 7.5 nmol/mmol) lost 2 times more bone mass than did those with Dpd levels below it. Dpd levels decreased significantly (p<0.01) from baseline at 6 months following initiation of treatment with 0.05 or 0.1 mg/day 17β-estradiol, changes that correlated with increased lumbar spine BMD and with changes in mid-radius BMC. At 12 months, Dpd levels were lower than baseline and placebo in all three treatment groups. These data suggest utility of this Dpd immunoassay in assessing changes in bone resorption induced by surgical menopause and ERT.

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Author notes

  1. R. P. Hesley

    Present address: Metrika Laboratories, Sunnyvale, California, USA

Authors and Affiliations

  1. Metra Biosystems, Inc., 265 North Whisman Road, 94043, Mountain View, CA, USA

    R. P. Hesley, K. A. Shepard & D. K. Jenkins

  2. Division of Endocrinology, Metabolism and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

    B. L. Riggs

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  1. R. P. Hesley
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  2. K. A. Shepard
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  3. D. K. Jenkins
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  4. B. L. Riggs
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Correspondence to D. K. Jenkins.

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Hesley, R.P., Shepard, K.A., Jenkins, D.K. et al. Monitoring estrogen replacement therapy and identifying rapid bone losers with an immunoassay for deoxypyridinoline. Osteoporosis Int 8, 159–164 (1998). https://doi.org/10.1007/BF02672513

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  • DOI: https://doi.org/10.1007/BF02672513

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