title: Bone mineral density in girls with functional hypothalamic amenorrhea subjected to estroprogestagen treatment--a 4-year prospective study.
abstract: The aim of this study was to evaluate the effects of 4-year estroprogestagen therapy (EP) on the bone mineral density (BMD) of 16- to 17-year-old girls with functional hypothalamic amenorrhea (FHA, n = 78). Baseline values of hormonal parameters, bone fraction of alkaline phosphatase (BALP), and cross-linked n-telopeptide of type I collagen (Ntx) were taken along with BMD measurements. Follow-up measurements of laboratory parameters were performed after 6 months of EP treatment. BMD was measured on a yearly basis. Six-month treatment resulted in a marked increase in estradiol levels and a significant decrease in BALP and Ntx. The relative increase in BMD was highest after the second year of treatment. Based on the dynamics of BMD changes during the first year of treatment, we identified a subgroup with no or insignificant reactions to the treatment. It was characterized by significantly higher baseline BMD and markedly lower baseline Ntx compared to the patients who responded to 1-year therapy well or extremely well. Further follow-up proved, however, that this subgroup did not differ significantly in terms of the long-term prognosis for BMD normalization. In conclusion, this study showed that EP therapy is effective in the treatment of BMD disorders associated with FHA.
authors.affiliation: Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, Szczecin, 71-252, Poland. klinendo@sci.pam.szczecin.pl
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Sowińska-Przepiera
authors.forename: Kornel
authors.initials: K
authors.lastname: Chełstowski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Friebe
authors.forename: Anhelli
authors.initials: A
authors.lastname: Syrenicz
mesh_terms: D000293:Adolescent; D000469:Alkaline Phosphatase / Q000378:metabolism; D000568:Amenorrhea / Q000188:drug therapy* / Q000378:metabolism; D015519:Bone Density; D024042:Collagen Type I / Q000378:metabolism; D004334:Drug Administration Schedule; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007028:Hypothalamic Hormones; D010455:Peptides / Q000378:metabolism; D011372:Progestins / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D024042:Collagen Type I; D007028:Hypothalamic Hormones; D010455:Peptides; D011372:Progestins; C052929:collagen type I trimeric cross-linked peptide; D004958:Estradiol; D000469:Alkaline Phosphatase