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document
Biochemical markers as predictors of bone mineral density changes after GnRH agonist treatment . 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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Intervention_Pharmacological
GnRH agonist
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Intervention_Pharmacological
hormone replacement therapy ( HRT )
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Intervention_Pharmacological
GnRH agonist
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Outcome_Other
efficacy
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Outcome_Physical
Z scores
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Outcome_Physical
bone alkaline phosphatase ( B-ALP )
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Outcome_Physical
osteocalcin ( OC )
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Outcome_Physical
imbalance in bone remodeling
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Outcome_Physical
high bone resorption
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Outcome_Physical
Bone mineral density ( BMD )
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Outcome_Physical
changes in BMD
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Outcome_Physical
Biochemical markers
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Outcome_Physical
urinary calcium and hydroxyproline
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Outcome_Physical
BMD changes at the lumbar spine
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Outcome_Physical
positive spine BMD changes
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Outcome_Physical
bone biochemical markers
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Outcome_Physical
association of B-ALP and D-Pyr
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Outcome_Physical
BMD variance
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Outcome_Physical
of B-ALP
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Outcome_Physical
PTH
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Outcome_Physical
estradiol
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Outcome_Other
biochemical bone markers
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Outcome_Physical
bone effect
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Participant_Condition
after GnRH agonist treatment .
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Participant_Condition
hormone replacement therapy