Relationship between weight and bone mineral density in adolescents on hormonal contraception.
OBJECTIVE
Since bone loss has been observed among adolescents on depot medroxyprogesterone acetate (DMPA), a clinical population that commonly experiences weight gain, we were interested in examining the direct relationship between body weight and bone mineral density (BMD) in adolescents on DMPA as compared to those on oral contraceptive pills (OC) or on no hormonal contraception (control).


METHODS
Prospective, Longitudinal study.


METHODS
Four urban adolescent health clinics in a large metropolitan area.


METHODS
Postmenarcheal girls, age 12-18 years, selecting DMPA, OC or no hormonal contraception.


METHODS
At baseline, 6, 12, 18, and 24 months, all study participants underwent measurement of weight and BMD of the hip and spine.


METHODS
The correlation between weight and BMD, and the correlation between change in weight and change in BMD were assessed at each time point.


RESULTS
Body weight was significantly (P < 0.05) positively correlated with femoral neck BMD and spine BMD at each time point regardless of contraceptive method. Change in body weight at 12 and 24 months was highly correlated with change in femoral neck BMD (P < 0.0001) for all treatment groups. No statistically significant correlation between change in weight and change in spine BMD was seen in the DMPA, OC, or control subjects at 12 or 24 months.


CONCLUSIONS
Weight gain on DMPA may mitigate loss of BMD among adolescent users.
Bonny
Andrea E
AE
Case Western Reserve University School of Medicine, Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio, USA. abonny@metrohealth.org
Secic
Michelle
M
Cromer
Barbara A
BA
D000293:Adolescent; D001835:Body Weight / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D015430:Weight Gain / Q000187:drug effects
D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate