title: Hypogonadism and hormone replacement therapy on bone mass of adult women with thalassemia major.
abstract: We studied bone mass and metabolism in 30 adult women (age 28.5 +/- 1.3) with thalassemia major (TM) and evaluated whether prolonged hormone replacement therapy (HRT) was able to optimize bone accrual. TM patients had reduced bone mass, increased bone turnover and lower serum gonadotropin and estradiol levels compared with 10 normal women of similar age. A significant correlation was found between bone mass and sex hormone levels. Six TM patients with normal ovarian function had normal bone turnover markers and modestly low bone mass (lumbar spine -1.29 +/- 0.31; femoral neck -0.60+/-0.21; Z-score). The other 24 TM women were hypogonadic and had significantly lower bone mass for age (lumbar spine -2.35 +/- 0.2, femoral neck -1.83 +/- 0.2) and increased bone turnover relative to eugonadal women. Of the hypogonadal patients, 13 had taken HRT since age 15 +/- 1 years, but their bone mass and turnover markers were not different than untreated hypogonadal patients. In conclusion, while hypogonadism negatively affects bone mass acquisition in adult TM women, HRT at the standard replacement doses is not sufficient to secure optimal bone accrual.
authors.affiliation: Department of Clinical Medicine and Emerging Pathologies, University of Palermo, Via del Vespro 147, 90127 Palermo, Italy. enricocarmina@libero.it
authors.forename: E
authors.initials: E
authors.lastname: Carmina
authors.forename: G
authors.initials: G
authors.lastname: Di Fede
authors.forename: N
authors.initials: N
authors.lastname: Napoli
authors.forename: G
authors.initials: G
authors.lastname: Renda
authors.forename: G
authors.initials: G
authors.lastname: Vitale
authors.forename: C
authors.initials: C
authors.lastname: Lo Pinto
authors.forename: D
authors.initials: D
authors.lastname: Bruno
authors.forename: R
authors.initials: R
authors.lastname: Malizia
authors.forename: G B
authors.initials: GB
authors.lastname: Rini
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D004958:Estradiol / Q000032:analysis; D005260:Female; D005640:Follicle Stimulating Hormone / Q000032:analysis; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000151:congenital / Q000188:drug therapy / Q000378:metabolism*; D007986:Luteinizing Hormone / Q000032:analysis; D017086:beta-Thalassemia / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone