Standard hormone therapy is inadequate for bone density in premature ovarian insufficiency

Abstract

To assess standard dose hormone therapy (HT) and bone mass in premature ovarian insufficiency (POI), 239 women with POI, 132 using standard estrogen dose HT and 107 women without HT, were evaluated. All underwent bone mineral density (BMD) evaluation in the lumbar spine (LS) and total femur (TF). Mean age, age at last period and body mass index (BMI) for the untreated and for the HT groups were 38.1 ± 6.1 and 36.8 ± 7.3 years; 31.4 ± 7.3 and 30.7 ± 7.2 years; 26.6 ± 7.1 and 25.8 ± 4.6 kg/m², respectively, (p=NS). The women taking standard dose HT started treatment at the age of 33.8 ± 6.3 years and had been on hormone treatment for 3 years at the time of the bone densitometry examination. The BMD in LS was 1.06 ± 0.15 and 1.00 ± 0.17 g/cm² (p = 0.003); the BMD in TF was 0.92 ± 0.19 and 0.91 ± 0.13 g/cm² (p = 0.039), respectively, for the untreated and HT groups. A 45% altered BMD (osteopenia/osteoporosis) in LS was verified in women without treatment and 60.1% in those using the standard dose TH (p = 0.01). The BMD in TF was altered in 32.3% in those without HT and 36.4% in the HT users (p = 0.34). In conclusion, standard dose HT was not adequate to reduce impaired bone mass in the spine and femur of women with POI.

Chinese abstract

为了评估卵巢早衰 ( POI) 患者的骨量和激素治疗 ( HT) 的标准剂量, 评估了239名患有POI的妇女, 其中有132名妇女使用了标准雌激素剂量的HT, 107名妇女未进行HT。对所有妇女进行了腰椎 ( LS) 和全股骨 ( TF) 的骨密度 ( BMD) 评估。未治疗组和HT组的平均年龄、末次月经年龄和体重指数 ( BMI) 分别为 38.1 ± 6.1 岁和36.8 ± 7.3 岁; 31.4 ± 7.3岁 和 30.7 ± 7.2 岁; 26.6 ± 7.1 kg/m²和 25.8 ± 4.6 kg/m², (p =NS)。妇女采用标准剂量HT的起始治疗年龄是33.8 ± 6.3岁, 并且在骨密度测定检查时已经进行了3年的激素治疗。未治疗组和HT组的LS骨密度分别为1.06 ± 0.15g/cm² 和1.00 ± 0.17 g/cm² (p = 0.003)；TF骨密度分别为0.92 ± 0.19 g/cm²和 0.91 ± 0.13 g/cm² (p = 0.039)。经证实, LS骨密度改变 ( 骨质减少/骨质疏松) 的妇女在未治疗组有45%, 在使用标准剂量HT组有60.1% ( p = 0.01) 。TF骨密度改变的妇女在未进行HT组有32.3%, HT组有 36.4% (p = 0.34)。总之, 标准剂量的HT不足以减少POI妇女脊柱和股骨的骨质受损。

Keywords:

• Bone mineral density
• hormone therapy
• osteoporosis
• premature ovarian insufficiency
• primary ovarian insufficiency

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This study was partially funded by and Research Support Foundation for the state of São Paulo (FAPESP). Brazil (FUNDING 2012/23669–0).