BONE MINERAL DENSITY AND VASCULAR WALL CHARACTERISTICS IN WOMEN AFTER OVARIECTOMY AND PROLONGED HORMONE THERAPY

Abstract

Osteoporosis and atherosclerosis are the most socially significant chronic non-infectious diseases. This is due to their high prevalence and medical, social and economic consequences from osteoporotic bone fractures and myocardial infarction and stroke as a result of cardiovascular diseases (CVD). The level of estrogen is essential for the formation and maintenance of bone mass in women. The sharp decline in estrogen levels after bilateral ovariectomy plays the role of trigger factor in the development of complex disorders of the bone and the cardiovascular system. Pathogenetically justified approach to the correction of the estrogen-deficient states is the use of hormone replacement therapy (HRT). To study the effect of HRT on the cardiovascular system and bone mineral density (BMD) we examined 50 women with surgical menopause which received HRT for more than a 10-year period. We studied the anthropometric and biochemical parameters (blood cholesterol and its fractions, fasting blood glucose), performed Doppler ultrasonography of head and neck vessels with measurement of pulse velocity, dual-energy x-ray absorptiometry (DEXA) for BMD estimation. Examination was carried out twice - in the early period after the operation (the first year) and after 10 years. Analysis of the cardio-vascular system and the BMD has demonstrated more severe atherosclerotic vascular changes and a greater decrease in BMD in patients who discontinued use of HRT. The severity of atherosclerosis and the level of the BMD were dependent on HRT use.