title: FSH Levels Predict Bone Loss in Premenopausal Women Treated for Breast Cancer More Than One Year After Treatment.
abstract: BACKGROUND
  Biomarkers to predict bone loss in premenopausal women after breast cancer treatment have not been examined.
  
  
  OBJECTIVE
  To determine whether baseline FSH predicts subsequent bone loss.
  
  
  METHODS
  Secondary data analysis of the Exercise for Bone Health: Young Breast Cancer Survivors study, in which women were randomized to a 12-month exercise program or monthly health newsletter.
  
  
  METHODS
  Community dwelling women.
  
  
  METHODS
  A total of 206 women age less than or equal to 55 years at breast cancer diagnosis who had received adjuvant chemotherapy and were at least 1 year after diagnosis.
  
  
  METHODS
  Serum collected at baseline (an average of 302 ± 148 d after completing chemotherapy) was analyzed for FSH.
  
  
  METHODS
  Change in bone mineral density.
  
  
  RESULTS
  In linear regression models, baseline FSH levels predicted bone loss over the ensuing 12 months at the lumbar spine and femoral neck including after adjustment for age, ethnicity, treatment group (exercise vs control), baseline bone density, and high-sensitivity C-reactive protein (P < .001). In multiply adjusted models, the 12-month rate of change in bone density was +0.007% in the lowest tertile of FSH (FSH = 9 ± 7 IU/L, mean ± SD), -0.96% in the middle tertile (mean FSH = 41 ± 11 IU/L), and -2.2% in the highest tertile (mean FSH = 86 ± 19 IU/L), P for trend <.001.
  
  
  CONCLUSIONS
  Among premenopausal women with breast cancer treated with chemotherapy, baseline FSH levels are strongly associated with subsequent bone loss. Further studies are needed to establish the optimal timing of FSH measurement in relation to breast cancer treatment and to investigate potential strategies to prevent bone loss.
authors.affiliation: Division of Endocrinology (L.S.T., D.E.S.), Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland 21224; Department of Health Policy and Management (J.B.), School of Public Health, University of California, Berkeley, California 94720; and Department of Public Health Sciences (S.S.), School of Medicine, University of California, Davis, California 95616.
authors.forename: Laila S
authors.initials: LS
authors.lastname: Tabatabai
authors.affiliation: Division of Endocrinology (L.S.T., D.E.S.), Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland 21224; Department of Health Policy and Management (J.B.), School of Public Health, University of California, Berkeley, California 94720; and Department of Public Health Sciences (S.S.), School of Medicine, University of California, Davis, California 95616.
authors.forename: Joan
authors.initials: J
authors.lastname: Bloom
authors.affiliation: Division of Endocrinology (L.S.T., D.E.S.), Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland 21224; Department of Health Policy and Management (J.B.), School of Public Health, University of California, Berkeley, California 94720; and Department of Public Health Sciences (S.S.), School of Medicine, University of California, Davis, California 95616.
authors.forename: Susan
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Division of Endocrinology (L.S.T., D.E.S.), Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland 21224; Department of Health Policy and Management (J.B.), School of Public Health, University of California, Berkeley, California 94720; and Department of Public Health Sciences (S.S.), School of Medicine, University of California, Davis, California 95616.
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Sellmeyer
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000534:rehabilitation; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005081:Exercise Therapy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D017697:Premenopause / Q000097:blood* / Q000187:drug effects; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D011379:Prognosis
chemical_list: D005640:Follicle Stimulating Hormone