title: Bone biochemical markers in adolescent girls using either depot medroxyprogesterone acetate or an oral contraceptive.
abstract: OBJECTIVE
  To examine the relationship between biochemical markers of bone metabolism and hormonal contraception in adolescents.
  
  
  METHODS
  A prospective, observational design.
  
  
  METHODS
  The study was conducted in four adolescent health clinics in a large metropolitan area.
  
  
  METHODS
  The study population comprised healthy, postmenarcheal adolescent girls aged 12-18 initiating either medroxyprogesterone acetate (n=53) or an oral contraceptive (OC) containing 20 mug ethinyl estradiol/100 mug levonorgestrel (n=165) and those using no hormonal contraception (n=152).
  
  
  METHODS
  None.
  
  
  METHODS
  Serum bone specific alkaline phosphatase (BSAP), urinary deoxypyridinoline (DPD), and bone mineral density (BMD) at baseline and 12 months.
  
  
  RESULTS
  At 12 month follow-up, serum BSAP levels were significantly higher (P < 0.05) in the control group (40.4 U/L +/- 1.03 SE), than in the DMPA group (35.2 U/L +/- 1.05 SE) and the OC group (35.5 U/L +/- 1.03 SE). There was a trend in urinary DPD levels to be higher (P=0.08) in the control group (9.9 nmol/mmol Cr +/- 1.03 SE) than in the DMPA group (9.1 +/- 1.05 SE) and the OC group (8.9 +/- 1.03 SE). No relationship was found between the biochemical markers and BMD at the lumbar spine or the femoral neck.
  
  
  CONCLUSIONS
  Over 12 months, there was evidence of increased bone formation and resorption in the control group when compared to that in the DMPA and OC groups. This finding may indicate a suppression of bone metabolism in girls using DMPA or an OC containing 20 mug ethinyl estradiol/100 mug levonorgestrel.
authors.affiliation: Children's Hospital at the Cleveland Clinic, Cleveland, Ohio, USA. romee@ccf.org
authors.forename: Ellen
authors.initials: E
authors.lastname: Rome
authors.forename: Julie
authors.initials: J
authors.lastname: Ziegler
authors.forename: Michelle
authors.initials: M
authors.lastname: Secic
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonny
authors.forename: Margaret
authors.initials: M
authors.lastname: Stager
authors.forename: Rina
authors.initials: R
authors.lastname: Lazebnik
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cromer
mesh_terms: D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000378:metabolism*; D015519:Bone Density; D001862:Bone Resorption; D001842:Bone and Bones / Q000378:metabolism*; D016022:Case-Control Studies; D003276:Contraceptives, Oral; D004997:Ethinyl Estradiol; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D003276:Contraceptives, Oral; D004997:Ethinyl Estradiol; D016912:Levonorgestrel; C036020:deoxypyridinoline; D017258:Medroxyprogesterone Acetate; D000469:Alkaline Phosphatase