Biochemical markers as predictors of bone mineral density changes after GnRH agonist treatment

D Borderie, B Cherruau, M Dougados, O G Ekindjian, C Roux
Calcified tissue international · 1998 · doi:10.1007/s002239900388 · PMID:9405728
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Bone biochemical markers measured at six months of GnRH agonist treatment correlated with lumbar spine bone mineral density changes after treatment cessation and resumption of menstruation.

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The study evaluated bone biochemical markers as predictors of changes in bone mineral density (BMD) during and after GnRH agonist treatment in 28 women with ovarian function suppression for 6 months, examining how cessation and return of ovarian function affected bone turnover. BMD decreased by 4.2% with evidence of an imbalance in remodeling marked by relatively high bone resorption, and biochemical markers measured at 6 months (with exceptions noted for urinary calcium and hydroxyproline) correlated with later BMD changes at the lumbar spine; however, BMD changes showed modest magnitudes and the sample was relatively small. After menstruation resumed, 13/28 showed positive spine BMD changes between months 6 and 12, and those women had higher biochemical marker levels at month 6. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

To evaluate bone biochemical markers as predictors of the efficacy of a hormone replacement therapy (HRT), we studied the bone changes induced by the cessation and return of ovarian function in 28 patients treated for 6 months with a GnRH agonist. This model reproduced the effects observed in postmenopausal women with high bone turnover treated with HRT. At the end of the treatment, Z scores were 1.8 +/- 0.3 for Crosslaps (CTx) and deoxypyridinoline (D-Pyr), and 1.1 +/- 0.2 for bone alkaline phosphatase (B-ALP) and osteocalcin (OC). This indicated an imbalance in bone remodeling with a high bone resorption. Bone mineral density (BMD) fell by 4.2 +/- 2.5%. The changes in BMD between the 6th and 12th months were 0. 34 +/- 2.24 and -1.73 +/- 3.25% at the lumbar spine and the femoral neck, respectively. Biochemical markers except urinary calcium and hydroxyproline measured at 6 months were positively correlated with the BMD changes at the lumbar spine. After the resumption of menstruation, 13 of 28 women displayed positive spine BMD changes between the 6th and 12th months; in this group, bone biochemical markers measured at 6 months were significantly higher (P = 0.02). Stepwise regression analysis showed that the association of B-ALP and D-Pyr measured at 6 months explained 40% of BMD variance and the association of B-ALP, PTH, and estradiol 56%. We conclude that measuring individual biochemical bone markers can help to predict the bone effect of an increase in the circulating estradiol in women with ovarian deficiency.
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Abstract. To evaluate bone biochemical markers as predictors of the efficacy of a hormone replacement therapy (HRT), we studied the bone changes induced by the cessation and return of ovarian function in 28 patients treated for 6 months with a GnRH agonist. This model reproduced the effects observed in postmenopausal women with high bone turnover treated with HRT. At the end of the treatment, Z scores were 1.8 ± 0.3 for Crosslaps (CTx) and deoxypyridinoline (D-Pyr), and 1.1 ± 0.2 for bone alkaline phosphatase (B-ALP) and osteocalcin (OC). This indicated an imbalance in bone remodeling with a high bone resorption. Bone mineral density (BMD) fell by 4.2 ± 2.5%. The changes in BMD between the 6th and 12th months were 0.34 ± 2.24 and −1.73 ± 3.25% at the lumbar spine and the femoral neck, respectively. Biochemical markers except urinary calcium and hydroxyproline measured at 6 months were positively correlated with the BMD changes at the lumbar spine. After the resumption of menstruation, 13 of 28 women displayed positive spine BMD changes between the 6th and 12th months; in this group, bone biochemical markers measured at 6 months were significantly higher (P= 0.02). Stepwise regression analysis showed that the association of B-ALP and D-Pyr measured at 6 months explained 40% of BMD variance and the association of B-ALP, PTH, and estradiol 56%. We conclude that measuring individual biochemical bone markers can help to predict the bone effect of an increase in the circulating estradiol in women with ovarian deficiency. Similar content being viewed by others Author information Authors and Affiliations Additional information Received: 16 January 1997 / Accepted: 17 June 1997 Rights and permissions About this article Cite this article Borderie, D., Cherruau, B., Dougados, M. et al. Biochemical Markers as Predictors of Bone Mineral Density Changes After GnRH Agonist Treatment. Calcif Tissue Int 62, 21–25 (1998). https://doi.org/10.1007/s002239900388 Published: Issue date: DOI: https://doi.org/10.1007/s002239900388

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endometriosis

MeSH descriptors

Biomarkers Biomarkers Bone Density Luteolytic Agents Triptorelin Pamoate Adult Alkaline Phosphatase Alkaline Phosphatase Alkaline Phosphatase Amenorrhea Amenorrhea Amino Acids Amino Acids Amino Acids Biomarkers Bone Density Calcium Calcium Cohort Studies Collagen

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