Urinary N-Telopeptides to Monitor Bone Resorption While on GnRH Agonist Therapy

L A Marshall, Lawrence M. Marshall, Marshall LA, D F Cain, Cain DF, W P Dmowski, Dmowski WP, Chesnut CH 3rd, C. H. Chesnut
Obstetrics and gynecology · 1996 · vol. 87(3) , pp. 350–354 · doi:10.1016/0029-7844(95)00424-6 · PMID:8598953 · W2078039950
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Urinary N-telopeptide levels increased during GnRH agonist therapy, correlating with decreased estradiol and potentially predicting bone mineral density loss.

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Abstract

OBJECTIVES: To assess the utility of urinary cross-linked N-telopeptides in monitoring bone resorption and predicting bone loss during GnRH agonist administration. METHODS: Ninety patients who were prescribed GnRH agonist therapy for 3-6 months for treatment of endometriosis, leiomyomas or other gynecologic disorders participated in this prospective multicenter study. N-telopeptides, serum estradiol (E2), and bone mineral density were monitored before, during and up to 3 months after the course of GnRH agonist therapy. RESULTS: N-telopeptide levels increased significantly throughout GnRH agonist therapy and returned to baseline levels by 3 months after treatment was completed. A significant negative correlation was seen between N-telopeptide and E2 measurements after 3 months (r=-0.23, P<.05), 4 months (r=-0.32, P < .05), and 5 months (r=-0.41, P<.005) of GnRH agonist therapy. The percent change in bone mineral density at L1-L4 at 6 months of GnRH agonist treatment correlated inversely with the percent change in N-telopeptides from baseline to 2,3,4, and 5 months of treatment; the percent change of bone mineral density at the femoral neck at 6 months correlated inversely with the percent change of N-telopeptides from baseline to month 4. CONCLUSIONS: Urinary N-telopeptide determinations provide a quantitative measure of bone resorption, due to GnRH agonist-induced hypoestrogenism. Increases in resorption as measured by N-telopeptides parallel decreases in in E2 levels. Increases in N-telopeptides on GnRH agonist therapy may provide a tool to predict decreases in bone mineral density.

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Condition tags

endometriosis

MeSH descriptors

Antineoplastic Agents, Hormonal Bone Resorption Collagen Genital Neoplasms, Female Gonadotropin-Releasing Hormone Leuprolide Peptides Adult Antineoplastic Agents, Hormonal Antineoplastic Agents, Hormonal Bone Density Bone Density Collagen Collagen Type I Endometriosis Endometriosis Estradiol Estradiol Female Follicle Stimulating Hormone

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