[Usefulness of the relationship between follicular stimulating hormone, deoxypyridinoline, estradiol, and inhibin as decision criterion for starting replacement hormone therapy in climacteric and its correlation with symptomatology].
BACKGROUND
There is no precise indication for the adequate moment to start hormone replacement therapy (HRT).


OBJECTIVE
To evaluate several indexes obtained with serum levels of follicle stimulating hormone (FSH), estradiol (E2), estrone (E) and inhibin and urinary deoxypyridinoline (DPD) and correlate them with Kupperman index as decision criteria for the beginning of hormone replacement therapy (HRT) in the climatery.


METHODS
In 53 patients the presence and intensity of climateric symptoms was evaluated using the modified Kupperman's index. They were divided in: premenopausal, perimenopausal or postmenopausal. groups FSH, E2, E and inhibin blood levels, as well as urinary DPD were measured. Several indexes were calculated, and then were compared between the groups and correlated with Kupperman's index score. Statistical analysis. Kruskall-Wallis and Mann-Whitney U test were done, as well as Spearman's correlation analysis.


RESULTS
After comparing the indexes, the Log FSH/E2, Log FSH/E2, Log FSH/E2/E, Log FSH(DPD)/E2, Log FSH(DPD)/E2/E and Log FSH (DPD)/Inhibin(E2) were significantly greater in postmenopausal group. Only there was a significant correlation between Log FSH/Inhibin(E2) index, and Log FSH(DPD)/Inhibin(E2) index with Kupperman's index.


CONCLUSIONS
Log FSH (DPD)/E2/E index seems to be the more suitable, index because it had a progressive increase as the patients advanced towards postmenopause. The afore mentioned index must be validated with a greater number of patients to assess a cut point that can define in which patients HRT must be administered.
Carranza Lira
S
S
Hospital de Gineco-Obstetricia Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, México, D.F., México.
Cortés Fuentes
E
E
González Legorreta
S L
SL
D000328:Adult; D000596:Amino Acids / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D020249:Hormone Replacement Therapy; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D013997:Time Factors
D000596:Amino Acids; D015415:Biomarkers; D004958:Estradiol; D007265:Inhibins; D005640:Follicle Stimulating Hormone; C036020:deoxypyridinoline