Abstract
OBJECTIVES: We investigated the effect of the menopause when followed longitudinally for a decade to evaluate whether women with an increased bone loss continue to have elevated urinary excretion of pyridinium cross-links later in menopause. Furthermore, we investigated the effect of oestrogen/progesterone therapy on the urinary excretion of pyridinium cross-links.
PARTICIPANTS: In the cross-sectional study: 18 healthy premenopausal, 142 healthy post-menopausal women and 41 osteopenic post-menopausal women. In the longitudinal study: 45 healthy post-menopausal women followed up for 7-10 years after the menopause; these women were further divided into two equal groups, according to their loss of forearm bone mineral content over 2 years. In the oestradiol/progesterone double-blind, placebo-controlled 2-year trial: early post-menopausal women were given either hormone replacement therapy (n = 38) or placebo (n = 16).
MEASUREMENTS: The urinary excretion of pyridinoline/creatinine (Pyr/Cr) and urinary deoxypyridinoline/creatinine (D-Pyr/Cr), two new markers of bone resorption.
RESULTS: Pyr/Cr and D-Pyr/Cr increased significantly after the menopause (Pyr/Cr, 77%; D-Pyr/Cr, 98%, P < 0.001). Hormone replacement therapy reversed this increase towards premenopausal levels. Both pyridinium cross-links remained fairly constant during the first decade of the menopause, when measured in the longitudinal study. When the women were divided according to loss in forearm BMC, those with a loss greater than 3.5%/2 years had significantly higher levels of pyridinium cross-links (P < 0.05-0.01). Furthermore, both Pyr/Cr and D-Pyr/Cr were significantly higher in elderly osteopenic women (aged 68-72 years) than in age-matched non-osteopenic women (P < 0.01-0.001).
CONCLUSIONS: Both Pyr/Cr and D-Pyr/Cr, two new markers of bone resorption, increased significantly at the time of the menopause, thereafter remaining fairly constant during the first post-menopausal decade. Women with increased bone loss continue to have elevated urinary excretion of pyridinium cross-links during the first decade of the menopause. This post-menopausal change is reversed by hormone replacement therapy to the premenopausal level.
Original language | English |
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Journal | Clinical Endocrinology |
Volume | 40 |
Issue number | 6 |
Pages (from-to) | 777-782 |
Number of pages | 6 |
ISSN | 0300-0664 |
DOIs | |
Publication status | Published - 1994 |
Externally published | Yes |
Keywords
- Adult
- Age Factors
- Aged
- Cross-Sectional Studies
- Estrogen Replacement Therapy
- Female
- Humans
- Longitudinal Studies
- Menopause
- Middle Aged
- Osteoporosis, Postmenopausal
- Postmenopause
- Pyridinium Compounds