Abstract
BackgroundHip structural analysis (HSA) is a method for evaluating bone geometry reflecting bone structural and biomechanical properties. However, tissue-selective estrogen complex (TSEC) treatment effects on HSA have not been investigated.ObjectiveThis study was performed to evaluate the effect of TSEC treatment on hip geometry in postmenopausal Korean women. The treatment was given for 12 months, and hip geometry was measured by HSA.Materials and MethodsA total of 40 postmenopausal women who received TSEC containing conjugated estrogen 0.45 mg and bazedoxifene 20 mg for treating vasomotor symptoms were included in this retrospective cohort study. The changes in bone mineral density and parameters of HSA including the outer diameter, cross-sectional area, cross-sectional moment of inertia, cortical thickness, section modulus, and buckling ratio as determined by dual-energy X-ray absorptiometry were compared before and after 12 months of TSEC treatment.ResultsMean age and years since menopause were 55.1 and 4.5 years, respectively. Total hip bone mineral density significantly increased by 0.74% after treatment (P=0.011). The changes in HSA were mainly demonstrated in the narrow femoral neck: cross-sectional area (P=0.003) and cortical thickness (P<0.001) increased significantly. For the shaft region, only SM decreased significantly after treatment (P=0.009). However, most parameters did not change significantly with TSEC treatment in the intertrochanteric and shaft regions.ConclusionsOur findings demonstrate that 12 months of TSEC treatment could improve bone geometry as measured by HSA. The findings suggest that TSEC might be an interesting option for the prevention of fracture as well as osteoporosis in postmenopausal women.
Highlights
Menopausal hormone therapy (MHT), estrogen alone, or estrogen-progestin combination, is effective for the prevention of osteoporosis and fractures in postmenopausal women [1, 2]
The inclusion criteria were: postmenopausal women [1] with an intact uterus, [2] who received tissue-selective estrogen complex (TSEC), [3] who were over 40 years old, [4] who were diagnosed with osteopenia at the femoral neck or total hip using DXA, and [5] who had results of bone densitometry and geometry before and after 12 months of TSEC use
Data are presented as mean ± standard error or number
Summary
Menopausal hormone therapy (MHT), estrogen alone, or estrogen-progestin combination, is effective for the prevention of osteoporosis and fractures in postmenopausal women [1, 2]. Experimental evidence suggests that most of the side effects and risks are related to the progestogen component, and a combined therapy of conjugated estrogen (CE) and bazedoxifene was developed recently and used worldwide as an alternative to conventional MHT. This new progestin-free tissue-selective estrogen complex (TSEC) would be a useful MHT option especially in women who cannot tolerate the side effects related to progestogens or who have a higher risk for breast cancer [1], and showed beneficial effects on bone mineral density (BMD) in previous studies [3,4,5]. Tissue-selective estrogen complex (TSEC) treatment effects on HSA have not been investigated
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