Prediction of the change in bone mineral density induced by gonadotropin-releasing hormone agonist treatment for endometriosis.
OBJECTIVE
To observe the long-term changes in bone metabolism induced by GnRH agonist (GnRHa) treatment and to determine the factor that affected the change in bone mineral density (BMD).


METHODS
Prospective observational study.


METHODS
Department of obstetrics and gynecology in university and general hospitals.


METHODS
Fifty women with endometriosis treated with GnRHa between 1994 and 1996.


METHODS
Leuprolide acetate administered for 24 weeks. Bone mineral density measurement by dual energy x-ray absorptiometry and collection of blood and urine samples were conducted until 12 months of posttreatment.


METHODS
Spinal BMD and bone turnover markers.


RESULTS
Mean BMD percent changes from pretreatment were -4.9% and -3.4% at 6 months of treatment and at 12 months of posttreatment, respectively. When the patients were divided by the median pretreatment deoxypyridinoline (DP) level, recovery of BMD after GnRHa discontinuation was slower in the Low-DP group than in the High-DP group. A significant positive correlation was found between the pretreatment DP level and the percent change in BMD at 12 months of posttreatment. No significant relation between BMD and the other bone turnover markers was noted.


CONCLUSIONS
Bone mineral density changes were diverse among patients who were administered GnRHa. The pretreatment DP level may be the predictive factor for GnRHa-induced BMD change.
Matsuo
Hiroya
H
Department of Maternity Nursing, Faculty of Health Sciences, Kobe University School of Medicine, Kobe, Japan. matsuoh@ams.kobe-u.ac.jp
D000328:Adult; D000469:Alkaline Phosphatase / Q000187:drug effects / Q000378:metabolism; D000596:Amino Acids / Q000378:metabolism / Q000652:urine; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D004715:Endometriosis / Q000188:drug therapy* / Q000503:physiopathology*; D004958:Estradiol / Q000378:metabolism; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008875:Middle Aged; D010446:Peptide Fragments / Q000187:drug effects / Q000378:metabolism; D011237:Predictive Value of Tests; D011347:Procollagen / Q000187:drug effects / Q000378:metabolism; D011446:Prospective Studies
D000596:Amino Acids; D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C042813:procollagen type I carboxy terminal peptide; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase; D016729:Leuprolide