[en] OBJECTIVE: To evaluate and compare the effects or oral and transdermal estrogen replacement therapy on biochemical markers of bone resorption in early postmenopausal women. DESIGN: Controlled, randomized group comparison. SETTING: Outpatient clinic for menopausal women and research into osteoporosis. SUBJECTS: Sixty healthy women menopausal for less than 5 years and who had never received any medications interfering with bone metabolism. INTERVENTIONS: The 60 women were randomly allocated to 3 months therapy with either oral conjugated estrogens (0.625 mg/day) (n = 28) or transdermal estradiol (50 micrograms/day) (n = 32) in cyclical combination with medroxyprogesterone acetate (5 mg/day). MAIN OUTCOME MEASURES: Traditional (urinary calcium/creatinine and hydroxyproline/creatinine) and the new specific (urinary pyridinoline/creatinine and deoxypyridinoline/creatinine) markers of bone resorption were determined before and after 3 months of treatment. RESULTS: In both groups, circulating levels of estrone and estradiol were significantly (P < 0.001) increased during treatment. In women treated with oral conjugated equine estrogens, urinary calcium/creatinine and hydroxyproline/creatinine ratios were significantly (P < 0.05) reduced. Pyridinoline/creatinine ratio fell from 69.1 (4) [mean (SEM)] to 50 (4) mumol/mumol (P < 0.01) and deoxypyridinoline/creatinine ratio fell from 10.8 (1) [mean (SEM)] to 8.3 (0.8) mumol/mumol (P < 0.01). In the group treated with transdermal estradiol, urinary hydroxyproline/creatinine ratio was significantly (P < 0.05) reduced. Pyridinoline/creatinine ratio fell from 66.3 (4) [mean (SEM)] to 46.2 (3) mumol/mumol (P < 0.01) and deoxypyridinoline/creatinine ratio fell from 11.5 (1.5) [mean (SEM)] to 7.7 (0.6) mumol/mumol (P < 0.01). There were no differences between the evolution of the biochemical variables in the two groups. CONCLUSION: These results suggest that oral conjugated equine estrogens and transdermal estradiol, in the given doses, are equally effective in reducing postmenopausal bone resorption.
Disciplines :
Rheumatology
Author, co-author :
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Christiansen, C.
Dequinze, B.
Deroisy, Rita ; Centre Hospitalier Universitaire de Liège - CHU > Médecine de l'appareil locomoteur
Gaspard, Ulysse ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Taquet, A. N.
Franchimont, P.
Language :
English
Title :
Effect of Transdermal 17 Beta-Estradiol and Oral Conjugated Equine Estrogens on Biochemical Parameters of Bone Resorption in Natural Menopause
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Riis B.J., Rodbro O., Christiansen C. (1986) The role of serum concentrations of sex steroids and bone turnover in the development and occurrence of postmenopausal osteoporosis. Calcif Tissue Int 38:318-322.
Lindsay R., Hart D.M., Forrest C., Baird C. (1980) Prevention of spinal osteoporosis in oophorectomized women. Lancet 2:1151-1153.
Christiansen C., Christensen, Mac Nair P., Hagen C., Stocklumd K., Transbol I. (1980) Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females. Eur J Clin Invest 10:273-279.
Horsman A., Jones M., Francis R., Nordin C. (1983) The effect of estrogen dose on postmenopausal bone loss. N Engl J Med 309:1405-1407.
Huppert L.C. (1987) Hormonal replacement therapy: benefits, risks, doses. Med Clin North Am 71:23-39.
Judd H. (1987) Efficacy of transdermal estradiol. Am J Obstet Gyn 156:1326-1331.
Ribot C., Tremollieres F., Pouilles J.M., Louvet J.P., Peyron (1989) Preventive effects of transdermal administration of 17beta-estradiol on postmenopausal bone loss: a 2-year prospective study. Gynecol Endocrinol 3:259-268.
Adami S., Suppi R., Bertoldo F., Rossini M., Residori M., Maresca V., Locascio V. (1989) Transdermal estradiol in the treatment of postmenopausal bone loss. Bone Miner 7:79-86.
Stevenson J.C., Cust M.P., Gangar K.F., Hillard T.C., Lees B., Whitehead M.I. (1990) Effects of transdermal versus oral hormone replacement therapy on bone density in spine and proximal femur in postmenopausal women. Lancet 2:265-269.
Delmas P.D., Donnez J., Chapuy M.C., Smets M., Meunier P.J. (1990) Short-term effects of transdermal 17beta-oestradiol (ESTRADERM TTS°) on bone metabolism in oophorectomized women: a placebo-controlled study. Osteoporosis 1990 , C., Christiansen, K., Overgaard, Osteopress ApS Publ, Copenhagen; 1985-1990.
Lufkin E.G., Hodgson S.F., Kotowicz M.A., O'Fallon W.M., Wahner H.W., Riggs B.L. (1990) The use of transdermal estrogen in treatment of osteoporosis. Osteoporosis 1990 , C., Christiansen, K., Overgaard, Osteopress ApS Publ, Copenhagen; 1995-1998.
Uebelhart D., Gineyts E., Chapuy M.C., Delmas P.D. (1990) Urinary excretion of pyridinium crosslinks: a new marker of bone resorption in metabolic bone disease. Bone Miner 8:87-96.
Nordin B.E.C. (1978) Diagnostic procedure in disorders of calcium metabolism. Clin Endocrinol 8:55-67.
Zerbe G.O. (1979) Randomization analysis of the completely randomized design extend to growth and response curves. Journal of the American Statistical Association 74:215-221.
Ettinger B., Genant H.K., Cann C.E. (1985) Long-term estrogen therapy prevents bone loss and fracture. Ann Intern Med 102:319-324.
Hutchinson T.A., Polanski J.M., Feinstein A.R. (1979) Postmenopausal oestrogens protect against fracture of hip and distal radius. Lancet 2:705-709.
Komm B.S., Terpening C.M., Benz D.J., Graeme K.A., Gallegos A., Korc M., Greene G.L., O'Malley B.W., Haussler (1988) Estrogen binding, receptor mRNA and biologic response in osteoblast-like osteosarcoma cells. Science 241:81-84.
Young M.M., Nordin B.E.C. (1967) Effects of natural and artificial menopause on plasma and urinary calcium and menopause. Lancet 2:118-120.
Nordin B.E.C., Polley K.J. (1987) Metabolic consequences of the menopause. A cross-sectional, longitudinal and intervention study on 557 normal postmenopausal women. Calcif Tissue Int 41(1 S):1-60.
Lindsay R., Hart D.M., Clark D.M. (1984) The minimum effective dose of estrogen for prevention of postmenopausal bone loss. Obstet Gynecol 63:759-763.
Ouyang P.C., Chow S.N., Huang S.C., Hsieh C.Y. (1986) Effect of estrogen (Premarin) replacement therapy on serum level of total estrogen and urinary excretion of calcium and hydroxyproline in postmenopausal Chinese women. Proc Natl Sci Counc B ROC 10:162-166.
Black D., Farquarson C., Robin S.P. (1989) Excretion of pyridinium cross-links of collagen in ovariectomized rats as urinary markers for increased bone resorption. Calcif Tissue Int 44:343-347.
Whittaker P.G., Morgan A., Dean P.D.G. (1980) Serum equilin, oestrone and oestradiol levels in postmenopausal women receiving conjugated equine oestrogens (Premarin). Lancet 1:14-16.
Varma T.R., Everard D., Hole D. (1985) Effect of natural estrogen on the serum level of follicle-stimulating hormone (FSH), estradiol and estrone in postmenopausal women and its effect on endometrium. Acta Obstet Gynecol Scand 64:105-109.
Reginster J.Y., Sarlet N., Deroisy R., Albert A., Gaspard U., Franchimont P. (1992) Minimal levels of serum estradiol to prevent postmenopausal bone loss. Calcif Tissue Int 51:340-343.
Powers, Schenkel L., Darley P.E., Good W.R. (1985) Pharmacokinetics and pharmacodynamics of transdermal dosage forms of l7beta-estradiol: comparison with conventional oral estrogens used for hormone replacement. Am J Gyn Obstet 152:1099-1106.
Selby P.L., Peacock M. (1986) Dose dependent response of symptoms, pituitary, and bone to transdermal oestrogen in postmenopausal women. Br Med J 293:1337-1339.
Steingold K.A., Laufer L., Chetkowski R.J., Defazio J.D., Matt D.W., Meldrum D.R., Judd H.L. (1985) Treatment of hot flashes with transdermal estradiol administration. J Clin Endocrinol Metab 61:627-632.
Chetkowski R.J., Meldrum D.R., Steingold K.A., Randle D., Lu J.K., Eggena P., Hershman J.M., Alkiaersig N.K., Fletcher A.P., Judd H.L. (1986) Biologic effects of transdermal estradiol. N Engl J Med 314:1615-1620.
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.