Bone Markers In Postmenopausal Women Research Articles

Association between the dietary inflammatory index and bone markers in postmenopausal women.

IntroductionThe health problem of postmenopausal women is emerging as an important problem due to the increased aging population. This study investigated the association between dietary inflammatory index (DII) and bone markers in postmenopausal women.MethodsA cross-sectional study was conducted on 132 postmenopausal women aged 45–70 years. The DII score was calculated using the 3-day food records and divided into tertiles according to the DII score. The lifestyle factors that could affect bone mineral density (BMD) in postmenopausal women were investigated and included the EuroQol- 5 Dimension (EQ-5D), physical activity, and eating habits. Skeletal muscle index-weight (SMIw) was used to evaluate skeletal muscle mass, and alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BSALP), and phosphorus (P) measured as bone biomarkers. The BMD was measured using dual-energy X-ray absorptiometry, and the association between anthropometric, biochemistry, BMD, and DII was assessed.ResultsIn the anti-inflammatory group, a high intake of fiber, vitamins, and minerals was observed. After adjusting for confound factors, with higher DII score, percent body fat increased (β = 0.168, p = 0.012), and SMIw decreased linear regression analysis (β = −0.329, p = 0.037, respectively). For biochemistry, confound factors were adjusted, with higher DII score, ALP, BSALP and P decreased and DII score increased (β = −0.057, p = 0.002, β = −0.167, p = 0.004, β = −1.799, p = 0.026, respectively). The relationship between DII and BMD was not significant, but osteopenia increased as DII score increased.ConclusionThe low DII score is positively associated with low body fat, high muscle mass, elevated bone markers, and low risk of osteopenia.

Vaginal health, endometrial thickness and changes in bone markers in postmenopausal women after 6 months of treatment with ospemifene in real clinical practice

Objective To assess vaginal health, endometrial thickness, and changes in bone markers in postmenopausal women with vulvovaginal atrophy (VVA) treated with 60 mg/day of ospemifene under routine clinical practice. Methods The AYSEX study is a Spanish observational and prospective study performed in one center in which 5 gynecologists recruited postmenopausal women with VVA in routine clinical practice treated continuously with ospemifene 60 mg/day for 12 months as an appropriate therapeutic option. This article refers to the 3- and 6-months analysis. Vaginal health was assessed by pH and using Vaginal Health Index (VHI) at baseline and 3 months later. Endometrial thickness, measured by vaginal ultrasonography, and bone resorption marker (CTx) were assessed at baseline and 6 months later. Results A total of 100 postmenopausal women cytologically and clinically diagnosed with VVA were included in the study. After 3 months of treatment with ospemifene, pH improved from 6.1 to 4.5 (p < .0001), and VHI improved from 10 to 19 points (p < .0001). The percentage of patients with VVA according to VHI decreased from 100% to 5.2% (p < .0001). After 6 months, mean CTx levels decreased from 0.42 pg/ml at baseline to 0.37 pg/ml 6 months later (p = .0018), and mean endometrial thickness changed from 2.24 to 2.15 mm (p = .6066). Conclusions Up to date, this is the only prospective and observational study with ospemifene in routine clinical practice conditions and confirms the results previously reported from randomized controlled clinical trials, improving VVA, not increasing endometrial thickness, and decreasing CTx levels by exerting an anti-resorptive function.

Commentary: Circulatory pattern of cytokines, adipokines and bone markers in postmenopausal women with low BMD.

Commentary: Circulatory pattern of cytokines, adipokines and bone markers in postmenopausal women with low BMD.

Estimation of bone mineral density and its correlations with homocysteine, and various other biochemical bone markers in postmenopausal women

Introduction- Omocysteine (HCY) prevents collagen cross-linking and activates osteoclast function within the bones. Bone mineral density (BMD) may be affected by Hyperhomocysteinemia via Cathepsin K. Aim- To find the correlation of BMD with biochemical bone markers. Methods- BMD was investigated by the DXA scan with the help of the Hologic QDR1000 system. As per WHO guidelines, subjects were divided into three different subsets with; normal bone mass, osteopenia, and osteoporosis. Every subject underwent routine biochemical laboratory investigations, HCY, Vitamin B12, and folic acid levels. Results-Among 355 postmenopausal women, 69% (245) had osteoporosis while 11.27% (40) had normal BMD (mean age, 53 ± 8.35 years) and 19.72% (70) had osteopenia (mean age 52.86 ± 7.93 years). The mean age in the osteoporotic group was 56.49 ± 6.65 years. The mean levels of HCY in the three groups were 15.58± 7.92 μmol/L, 16.13± 7.34μmol/L and 17.05± 5.13μmol/L, respectively. Hip BMD showed a strong inverse correlation with age (r=-0.360, p=0.002), while no significant correlations were found between weight and BMI. PTH was consistently seen to be negatively correlated with BMD at Spine (r=-0.0339, p=0.004), Forearm (r=-0.267, p=0.027), and Hip (r=-0.224, p=0.064). Conclusion- Low BMD is an important problem in postmenopausal female patients. Age and duration of menopause are independent risk predictors for the development of osteoporosis. Vitamin D levels do not predict low BMD in postmenopausal females. Weight is protective for osteoporosis especially at spine and forearm BMD. Vitamin B12 and Hcy levels did not correlate with low BMD.

Circulatory pattern of cytokines, adipokines and bone markers in postmenopausal women with low BMD.

Objective: In addition to some well-characterized bone turnover markers (BTMs), cytokines and adipokines have also been suggested to be linked to osteoporosis seen in menopause. However, there is much controversy on the possible association between these markers and bone mineral density (BMD). This study was aimed at measuring circulatory levels of selected cytokines, adipokines and BTMs in postmenopausal women with normal and low BMD.Methods: The study population included 71 post-menopausal women, of whom 25 had normal BMD, 31 had osteopenia and 13 had osteoporosis. Circulatory levels of selected pro-resorptive (TNF-α, IL-1β, IL-6, IL-8, IL-12, IL-17), anti-resorptive (IFN-γ, IL-4, IL-10, IL-13, TGF-β) and five adipokine markers (adiponectin, adipsin, lipocalin-2/NGAL, PAI-1 and resistin) were measured using the Multiplex system and read on the Magpix ELISA platform. Further, two bone turnover markers (PINP, CTX) as well as estradiol levels were assayed from the same samples.Results: While circulatory levels of cytokines were comparable between groups, women with low BMD had statistically significantly higher median circulatory levels of adipokines as compared to those with normal BMD. Further, while levels of CTX were not different between the two groups; PINP, PINP/CTX ratio and estradiol levels were significantly lower in women with low BMD. Levels of adiponectin, PINP, PINP/CTX ratio and estradiol correlated significantly with BMD of the hip and spine.Conclusion: The associations between various markers and BMD are complex and multivariate. Our data provide insights into the possible use of circulatory levels of cytokines, adipokines and bone turnover markers on the pathogenesis of postmenopausal osteoporosis because of the well-documented effects of these molecules on bone tissue and their relevance to osteoporosis.

Evaluation of bone mineral density and its correlation with homocysteine and other biochemical bone markers in postmenopausal women

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Osteoporosis is more common in post-menopausal women. Early detection of bone loss by bone mineral density helps to confirm the diagnosis of osteoporosis and assesses the future risk of osteoporotic fractures. Recent studies have revealed the association between increased plasma concentrations of homocysteine (Hcy), and reduced bone mineral density. Nevertheless, inconsistencies persist in the literature. Thus, the need for this study arose to investigate the possible relationship between serum Hcy status and bone mineral density on a group of post-menopausal women.&lt;strong&gt; &lt;/strong&gt;The objective of the study was to assess bone mineral density (BMD) in postmenopausal women and to correlate the same with biochemical bone markers like homocysteine, serum alkaline phosphatase (ALP), calcium and phosphorous levels.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; One hundred (100) postmenopausal women were recruited to enter this cross-sectional study. Out of which 86 postmenopausal females, were grouped into osteopenic and osteoporotic based on low t –scores. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DEXA) and serum Hcy, serum ALP, calcium and phosphorus levels were estimated. The relationship of Hcy with BMDand other biochemical markers was estimated using Pearson’s correlation.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Serum Hcy levels were significantly higher in osteoporotic women when compared to other BMD groups, and were inversely correlated with BMD. No statistical difference was seen with other biochemical bone markers like calcium, Phosphorus and ALP.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study shows that Hcy status is associated with BMD in osteoporotic postmenopausal women. BMD evaluation in postmenopausal women with high Hcy levels may have prognostic and therapeutic potentials, which needs to be explored through further Prospective studies.&lt;/p&gt;

Effect of age and estrogen on biochemical markers of bone turnover in postmenopausal women: a population-based study from Nepal.

BackgroundOsteoporosis, a common disease worldwide, is characterized by low bone mass and architectural deterioration of bone tissue, leading to enhanced bone fragility and increase in fracture risks. Both menopause and aging are related factors leading to greater risk of bone disease, particularly among postmenopausal women. Hence, the main purpose of this study was to investigate the differences in biochemical markers of bone turnover and to evaluate the association of hormones and age-related factors with biochemical markers between pre- and postmenopausal women.MethodsA descriptive cross-sectional study was conducted over a period of 6 months among the female population of Dholahity community, Lalitpur, Nepal. A total of 496 healthy women were selected based on the questionnaire strategy. Among them, 244 were premenopausal and 252 were postmenopausal women. Different bone markers were evaluated as per the guideline provided by the reagent manufacturer, and hormonal assay, particularly estradiol level assessment, was performed by chemiluminescence immunoassay-based technique.ResultsA significant decrease in serum calcium level and estradiol level was observed in postmenopausal women as compared to premenopausal women, whereas a significant increase in serum phosphorus and alkaline phosphatase (ALP) levels was seen among postmenopausal (p<0.001). Age was significantly correlated with bone markers (ALP and calcium) in postmenopausal group (p<0.005), while there was no significant correlation in premenopausal group. In addition, there was significant positive correlation between calcium and estradiol in postmenopausal women, while ALP was negatively correlated with estradiol in that group. Further, no significant correlation was demonstrated between estradiol and bone markers in postmenopausal women in body mass index and age-adjusted partial correlation analysis.ConclusionTimely diagnosis of osteoporosis in women would be of significant benefit for effective care for required populations and help to minimize mortality rate and financial burden of our country.

Feasibility of a clinical trial to assess the effect of dietary calciumv.supplemental calcium on vascular and bone markers in healthy postmenopausal women

Whether supplemental Ca has similar effects to dietary Ca on vascular and bone markers is unknown. The present trial investigated the feasibility of applying dietary and supplemental interventions in a randomised-controlled trial (RCT) aiming to estimate the effect of supplemental Ca as compared with dietary Ca on vascular and bone markers in postmenopausal women. In total, thirteen participants were randomised to a Ca supplement group (CaSuppl) (750 mg Ca from CaCO3+450 mg Ca from food+20 µg vitamin D supplement) or a Ca diet group (CaDiet) (1200 mg Ca from food+10 µg vitamin D supplement). Participants were instructed on Ca consumption targets at baseline. Monthly telephone follow-ups were conducted to assess adherence to interventions (±20 % of target total Ca) using the multiple-pass 24-h recall method and reported pill count. Measurements of arterial stiffness, peripheral blood pressure and body composition were performed at baseline and after 6 and 12 months in all participants who completed the trial (n 9). Blood and serum biomarkers were measured at baseline and at 12 months. Both groups were compliant to trial interventions (±20 % of target total Ca intake; pill count ≥80 %). CaSuppl participants maintained a significantly lower average dietary Ca intake compared with CaDiet participants throughout the trial (453 (sd 187) mg/d v. 1241 (sd 319) mg/d; P<0·001). There were no significant differences in selected vascular outcomes between intervention groups over time. Our pilot trial demonstrated the feasibility of conducting a large-scale RCT to estimate the differential effects of supplemental and dietary Ca on vascular and bone health markers in healthy postmenopausal women.

Efficacy of a Once-Monthly Pill Containing Ibandronate and Cholecalciferol on the Levels of 25-Hydroxyvitamin D and Bone Markers in Postmenopausal Women with Osteoporosis.

BackgroundThe present study evaluated the efficacy of a combination of ibandronate and cholecalciferol on the restoration of the levels of 25-hydroxyvitamin D (25[OH]D) and various bone markers in postmenopausal women with osteoporosis.MethodsThis was a randomized, double-blind, active-controlled, prospective 16-week clinical trial conducted in 20 different hospitals. A total of 201 postmenopausal women with osteoporosis were assigned randomly to one of two groups: the IBN group, which received a once-monthly pill containing 150 mg ibandronate (n=99), or the IBN+ group, which received a once-monthly pill containing 150 mg ibandronate and 24,000 IU cholecalciferol (n=102). Serum levels of 25(OH)D, parathyroid hormone (PTH), and various bone markers were assessed at baseline and at the end of a 16-week treatment period.ResultsAfter 16 weeks of treatment, the mean serum levels of 25(OH)D significantly increased from 21.0 to 25.3 ng/mL in the IBN+ group but significantly decreased from 20.6 to 17.4 ng/mL in the IBN group. Additionally, both groups exhibited significant increases in mean serum levels of PTH but significant decreases in serum levels of bone-specific alkaline phosphatase and C-telopeptide of type 1 collagen (CTX) at 16 weeks; no significant differences were observed between the groups. However, in subjects with a vitamin D deficiency, IBN+ treatment resulted in a significant decrease in serum CTX levels compared with IBN treatment.ConclusionThe present findings demonstrate that a once-monthly pill containing ibandronate and cholecalciferol may be useful for the amelioration of vitamin D deficiency in patients with postmenopausal osteoporosis. Moreover, this treatment combination effectively decreased serum levels of resorption markers, especially in subjects with a vitamin D deficiency, over the 16-week treatment period.

Interrelationships between obesity and bone markers in post-menopausal women with either obesity or osteoporosis

PurposeObesity and bone metabolism are interrelated. The aim of this study is to investigate the relationship between obesity and bone markers, leptin and insulin resistance in post-menopausal osteoporosis. Material and methodsFour study groups were included in the study. Group 1 (n=19): osteoporosis (T-score<–2.5 at the lumbar spine and/or femoral neck)+obese; group 2 (n=29): non-osteoporosis+obese; group 3 (n=25): osteoporosis+non-obese and as control group (n=14): non-osteoporosis+non-obese. The serum levels of osteoprotegerin (OPG; osteoclastogenic marker), RECEPTOR activator of nuclear factor ligand (RANKL; osteoclastic marker), tartarate resistant acid phosphatase (TRAP; osteoclastic marker), bone alkaline phosphatase (b-ALP; osteoblastic marker) and leptin were measured by ELISA. Glucose and insulin levels were analyzed by colorimetric and electrochemiluminescence methods. ResultsOPG and b-ALP levels were significantly lower in group 1 compared to group 2 (P<0.05 and P<0.01). Comparison of group 1 with group 3 revealed significantly higher leptin levels in the former (P<0.001). OPG, TRAP, RANKL, bone ALP were significantly lower (P<0.001, P<0.001, P<0.01, P<0.01) and leptin levels higher (P<0.05) in group 1 compared to control group. Comparison of group 3 with control group revealed significantly lower values of OPG, RANKL, bone ALP, TRAP for the patient group (P<0.001, P<0.01, P<0.01, P<0.001). OPG, RANKL, bone ALP, TRAP levels were significantly lower (for each P<0.01) and leptin levels were significantly higher (P<0.05) in group 2 compared to control group. ConclusionOsteoprotegerin, TRAP, RANKL, bone ALP and leptin levels can be used as significant markers in the development of osteoporosis and/or obesity in post-menopausal women.

12 Everolimus Added to Exemestane Reduced Bone Markers in Postmenopausal Women with Advanced Breast Cancer (ABC): the BOLERO-2 Trial

12 Everolimus Added to Exemestane Reduced Bone Markers in Postmenopausal Women with Advanced Breast Cancer (ABC): the BOLERO-2 Trial

11 Everolimus (Rad001) as Treatment in Breast Cancer Patients with Bone Metastases Only – First Results of the Multi-centre, Placebo-controlled, Randomized Discontinuation Phase II RADAR Study

not received. 10 Invited Modulation of Resistance to Hormonal Agents Abstract not received.not received. 11 Proffered paper oral Everolimus (Rad001) as Treatment in Breast Cancer Patients with Bone Metastases Only − First Results of the Multi-centre, Placebo-controlled, Randomized Discontinuation Phase II RADAR Study N. Harbeck, N. Maass, C. Mundhenke, C. Lerchenmuller, J. Barinoff, J. Ettl, B. Aktas, V. Nekljudova, G. von Minckwitz, S. Loibl. Unifrauenklinik Koln, Brustzentrum, Koln, Germany; Universitatsfrauenklinik Aachen, Gynakologie und Geburtshilfe, Aachen, Germany; Universitatsklinikum Kiel, Gynakologie und Geburtshilfe, Kiel, Germany; Gemeinschaftspraxis, Onkologie, Munster, Germany; Dr.-Horst-Schmidt-Kliniken, Gynekologie und Onkologie, Wiesbaden, Germany; Klinikum rechts der Isar, Frauenklinik, Munchen, Germany; Universitatsklinikum Essen, Klinik fur Frauenheilkunde und Geburtshilfe, Essen, Germany; German Breasts Group, Statistic Department, Neu-Isenburg, Germany; German Breasts Group, Medicine and Research, Neu-Isenburg, Germany Background: RAD001 is an orally bioavailable rapamycin ester analogue, which acts by selectively inhibiting mTOR (mammalian target of rapamycin). mTor is a key player in down stream signaling of different pathways In vitro, RAD001 stops formation and activity of osteoclasts. Therefore, treating advanced breast cancer with progressive bone metastases with RAD001 seems to be reasonable. Patients and Methods: We evaluated RAD001 in a placebo-controlled, phase II, randomized discontinuation study in breast cancer patients (pts) with bone metastases only. Pts were eligible if they had HER2-negative, hormone-receptor (HR)-positive or -negative disease, with a maximum of 2 previous lines of endocrine therapy (ET) and 1 previous line of chemotherapy (CT). All pts received zoledronate and pts with HR-positive disease could receive (ET). All pts started with RAD001 during a run-in phase of 8 weeks. Pts with stable disease were randomized to RAD001 or placebo; pts with response continued with RAD001 and pts with progression went off study. Primary outcome was time to progression (TTP) in pts being stable on 8 weeks of RAD001. Main secondary objectives were response rate after 8 weeks, TTP in pts with a response after 8 weeks of RAD001, overall clinical benefit, safety and toxicity of RAD001. It was assumed that placebo would obtain a median TTP of 8 weeks which would then be increased by to 16 weeks (hazard rate of 2), thus requiring 76 randomized pts. It was expected that 70% of all pts would have stable disease after the run-in phase. Overall, 110 pts were planned for enrollment. Due to slow recruitment and a dysbalance between pts randomized and discontinued, study recruitment stopped in December 2012. Results: From 11/06 until 12/10, 89 pts were enrolled. Median age was 59.5 years. All were HER2-negative, 93% had HR-positive disease. 15% had prior chemotherapy; 58% had prior ET for metastases. 1/3 received concomitant ET. Three pts did not start therapy, 41 discontinued during run-in phase, 32 due to progression. Six continued as responder, of whom three are still on treatment. 39 pts. with SD after the run in phase were randomized to RAD001 or placebo. Twenty-seven stopped due to progression; 9 discontinued due to AE, 4 are still on treatment. Conclusion: This is the first trial recruiting pts with bone metastases only for treatment with RAD001. Overall 7/89 showed a sustained response on RAD001 + zoledronate ± ET. Final analysis will be presented at the meeting. 12 Proffered paper oral Everolimus Added to Exemestane Reduced Bone Markers in Postmenopausal Women with Advanced Breast Cancer (ABC): the BOLERO-2 Trial M. Gnant, G.N. Hortobagyi, H. Rugo, H.A. Burris, S. Noguchi, K.I. Pritchard, J. Baselga, T. Sahmoud, H. Bauly, M. Piccart. Medical University of Vienna, Department of Surgery, Vienna, Austria; University of Texas MD Anderson Cancer Center, Department of Breast Medical Oncology, Houston, USA; University of California San Francisco, Helen Diller Family Comprehensive Cancer, San Francisco, USA; Sarah Cannon Research Institute, Drug Development Program, Nashville, USA; Osaka University, Department of Breast and Endocrine Surgery, Osaka, Japan; Sunnybrook Odette Cancer Center and the University of Toronto, Department of Medicine, Toronto, Canada; Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Boston, USA; Novartis Pharmaceuticals Corporation, Global Oncology Department, Florham Park, USA; Novartis Pharma AG, Biostatistics, Basel, Switzerland; Jules Bordet Institute, Department of Medicine,

Serum Bisphenol A Concentration in Postmenopausal Women with Osteoporosis

ObjectivesBishphenol A (BPA) is a representative endocrine disruptor and is also known as a xenoestrogen. The objective of the present study is to investigate how many patients are exposed to BPA and to analyze the relationships between serum BPA concentration, bone mineral density (BMD) and biochemical bone markers in postmenopausal women with osteoporosis.MethodsTotal 51 patients were enrolled for measuring BPA and clinical variables including BMD and bone markers. The relationship between BPA and clinical variables were analyzed by the Pearson's correlation test and the Kruskal-Wallis test. Serum BPA concentration was measured by enzyme linked immunosorbent assay (ELISA).ResultsBPA was detected in all samples. The mean BPA concentration was 1.44 ± 0.52 ng/mL. There was no statistically significant correlation between BPA and clinical variables.ConclusionThere was no statistical significance between serum BPA concentration and clinical variables related to bone metabolism. To clarify the effect of BPA on bone metabolism, further large scaled and high risk group investigation may be needed.

Effects of a safflower tea supplement on antioxidative status and bone markers in postmenopausal women

We conducted this study to examine the effects of safflower seed granular tea containing physiologically active polyphenols on antioxidative activities and bone metabolism. Forty postmenopausal women ages 49 to 64-years were recruited from Daegu and Gyeongbuk and were randomly assigned to either a safflower tea supplement (Saf-tea) group (n = 27) or a placebo group (n = 13). The Saf-tea group received 20 g of safflower seed granule tea per day containing a 13% ethanol extract of defatted safflower seeds, whereas the placebo group received a similar type of tea that lacked the ethanol extract. No significant changes in nutrient intake for either the placebo or Saf-tea groups were observed before or after the study period, except vitamin A intake increased after 6 months in the Saf-tea group. Dietary phytoestrogen intakes were similar in the Saf-tea group (60.3 mg) and placebo group (52.5 mg). Significant increases in plasma genistein and enterolactone were observed in the Saf-tea group. After 6 months of supplementation, serum levels of antioxidant vitamins such as α-tocopherol and ascorbic acid increased significantly, and TBARS levels decreased in the Saf-tea group compared to the placebo group. Serum osteocalcin levels were reduced (P < 0.05) in the Saf-tea group after 6 months, whereas serum osteocalcin did not change in the placebo group. Urinary deoxypyridinoline/creatinine excretion was not different between the two groups at baseline, and did not change in either group after 6 months. Bone mineral density decreased significantly in the placebo group (P < 0.01) but not in the supplemented group. It was concluded that polyphenols (72 mg/day), including serotonin derivatives, in the Saf-tea had both antioxidant and potential bone protecting effects in postmenopausal women without liver toxicity.

Effect of endogenous estradiol levels on bone resorption and bone mineral density in healthy postmenopausal women: a prospective study

Objective To investigate the effect of endogenous estrogens on bone mineral density (BMD) and bone markers in postmenopausal women over 24 months.Methods Fifty out of 99 postmenopausal women seen previously were re-assessed after 24 months. Levels of BMD, bone markers, serum estradiol (E2) and total testosterone were determined.Results BMD decreased in the femoral neck (∼2%) (p < 0.008), but remained stable in the other skeletal areas; E2 and serum Crosslaps (sCTX) decreased by 34% (p < 0.001) and 21% (p < 0.003), respectively. Women aged ≤ 65 years exhibited decreased BMD only in the femoral neck (2%, p < 0.01), without changes in bone markers. Women aged > 65 years exhibited a decrease in sCTX levels and stable BMD values at all skeletal sites. E2 levels decreased similarly in both groups (∼35%). Women with baseline E2 levels ≥ 10 pg/ml showed stable BMD in spite of their E2 levels decreasing by 42% (p < 0.001); sCTX decreased by 21% (p < 0.01). Women with baseline E2 levels < 10 pg/ml showed a 2% decrease (p < 0.001) in femoral neck BMD and a 19% decrease (p < 0.002) in E2 levels, without changes in bone markers.Conclusion Although endogenous E2 decreased to around 7 pg/ml in these menopausal women, this level would seem to be sufficient to maintain BMD in almost all skeletal areas, and to be more effective in older women.

Does apolipoprotein E genotype relate to BMD and bone markers in postmenopausal women?

Objectives: Bone mineral density (BMD) and development of osteoporosis are partly determined by genetic factors. The associations between one of suggested candidate, apolipoprotein E (apo E) genotype to bone mineral density (BMD) and bone biochemical markers was studied in 464 subjects recruited from a population-based group of early postmenopausal women ( n=13 100). Additionally, the influence of apo E genotype on BMD changes during a 5-year follow-up with or without hormone replacement therapy (HRT) was investigated. Methods: Participants were randomized into two treatment groups: HRT group: Sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate with or without vitamin D 3, 100–300 IU/day+calcium lactate, 500 mg/day ( n=232), and the non-HRT group: Calcium lactate, 500 mg/day alone or in combination with vitamin D 3, 100–300 IU/day ( n=232). BMD was measured from the lumbar spine and proximal femur at baseline and after 5 years of treatment ( n=352). In a subgroup ( n=59), the serum concentrations of bone biochemical markers (intact osteocalcin (OC), bone-specific alkaline phosphatase (BAP) and type I collagen carboxy-terminal telopeptide (ICTP)) were measured at baseline and after 1 year of follow-up. Results: At baseline, the BMDs were similar between the five apo E genotype groups (2/3, 2/4, 3/3, 3/4, 4/4). No significant differences in lumbar or femoral neck BMDs of women with the apo E4 allele were found compared with those without it. There was a statistically significant difference in 5-year BMD changes between the HRT and non-HRT groups. After 5 years, the BMD of the femoral neck had remained constant and the mean lumbar spine BMD had increased by 1.5% in the HRT group, whereas both BMDs had decreased by 4–5% in the non-HRT group. However, the apo E genotype did not modify the changes in BMD in either group. Additionally, the baseline concentrations of bone metabolic markers and their 1-year changes showed no genotype-related associations. Conclusions: The results of our population-based study indicate that apo E genotype does not modify lumbar or femoral neck BMDs or serum bone biochemical markers or their response to HRT in early postmenopausal Caucasian women.

Bone Mineral Density and Biochemical Bone Markers in Postmenopausal Women Following 12 Months of Sublingual Micronized Estrogen and Progesterone Therapy. With and Without the Addition of Micronized Testosterone

Miller, B E PhD; Percival, L C MS; Slade, K L APRN.; De Souza, M J PhD.; Luciano, A A MD. Author Information