Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients
Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/12/3961 |
| _version_ | 1797545546265657344 |
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| author | Agnieszka Podfigurna Marzena Maciejewska-Jeske Malgorzata Nadolna Paula Mikolajska-Ptas Anna Szeliga Przemyslaw Bilinski Paulina Napierala Blazej Meczekalski |
| author_facet | Agnieszka Podfigurna Marzena Maciejewska-Jeske Malgorzata Nadolna Paula Mikolajska-Ptas Anna Szeliga Przemyslaw Bilinski Paulina Napierala Blazej Meczekalski |
| author_sort | Agnieszka Podfigurna |
| collection | DOAJ |
| description | Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. <b>Purpose:</b> The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). <b>Materials and methods:</b> This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-β-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. <b>Results:</b> Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm<sup>2</sup>) vs. 1.150 ± 0.30 g/cm<sup>2</sup>) (<i>p</i> = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. −0.144 ± 0.82) (<i>p</i> = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; <i>p</i> < 0.001), T-score (−0.75 ± 1.17 vs. −0.59 ± 1.22; <i>p</i> < 0.001), and Z-score (−0.75 ± 1.12 vs. −0.49 ± 1.11; <i>p</i> < 0.001) after the implementation of HRT when compared to pre-treatment results. <b>Conclusions:</b> In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients. |
| first_indexed | 2024-03-10T14:16:58Z |
| format | Article |
| id | doaj.art-d4fa08cad59545f1a16ec88864385feb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T14:16:58Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d4fa08cad59545f1a16ec88864385feb2023-11-20T23:45:02ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-01912396110.3390/jcm9123961Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency PatientsAgnieszka Podfigurna0Marzena Maciejewska-Jeske1Malgorzata Nadolna2Paula Mikolajska-Ptas3Anna Szeliga4Przemyslaw Bilinski5Paulina Napierala6Blazej Meczekalski7Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandDepartment of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandStudents Scientific Society of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandStudents Scientific Society of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandDepartment of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandThe President Stanislaw Wojciechowski State University of Applied Sciences in Kalisz, 62-800 Kalisz, PolandDepartment of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandDepartment of Gynecological Endocrinology, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, PolandPremature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. <b>Purpose:</b> The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). <b>Materials and methods:</b> This study included 132 patients with a mean age of 31.86 ± 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 ± 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-β-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 ± 2 years. <b>Results:</b> Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 ± 0.14 g/cm<sup>2</sup>) vs. 1.150 ± 0.30 g/cm<sup>2</sup>) (<i>p</i> = 0.04) as well as a decreased T-score (0.75 ± 1.167 vs. −0.144 ± 0.82) (<i>p</i> = 003). There was a significant increase in BMD (1.088 ± 0.14 vs. 1.109 ± 0.14; <i>p</i> < 0.001), T-score (−0.75 ± 1.17 vs. −0.59 ± 1.22; <i>p</i> < 0.001), and Z-score (−0.75 ± 1.12 vs. −0.49 ± 1.11; <i>p</i> < 0.001) after the implementation of HRT when compared to pre-treatment results. <b>Conclusions:</b> In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients.https://www.mdpi.com/2077-0383/9/12/3961premature ovarian insufficiencyDXAosteoporosismenopausebone mineral density |
| spellingShingle | Agnieszka Podfigurna Marzena Maciejewska-Jeske Malgorzata Nadolna Paula Mikolajska-Ptas Anna Szeliga Przemyslaw Bilinski Paulina Napierala Blazej Meczekalski Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients Journal of Clinical Medicine premature ovarian insufficiency DXA osteoporosis menopause bone mineral density |
| title | Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients |
| title_full | Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients |
| title_fullStr | Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients |
| title_full_unstemmed | Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients |
| title_short | Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients |
| title_sort | impact of hormonal replacement therapy on bone mineral density in premature ovarian insufficiency patients |
| topic | premature ovarian insufficiency DXA osteoporosis menopause bone mineral density |
| url | https://www.mdpi.com/2077-0383/9/12/3961 |
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