title: Bone Mineral Density and Weight Changes in Adolescents Randomized to 3 Doses of Depot Medroxyprogesterone Acetate.
abstract: OBJECTIVE
  To assess the association between medroxyprogesterone acetate exposure and bone mineral density (BMD) loss and weight change in adolescents.
  
  
  METHODS
  Forty-eight-week prospective, randomized trial conducted May 2012-April 2014.
  
  
  METHODS
  Recruitment occurred in the general community and outpatient clinics in central Ohio.
  
  
  METHODS
  Self-referred sample of 34 female adolescents aged 12-21 years initiating depot medroxyprogesterone acetate (DMPA).
  
  
  METHODS
  Randomization to 1 of 3 DMPA doses (150, 104, or 75 mg) given intramuscularly every 12 weeks for 48 weeks.
  
  
  METHODS
  Absolute and percent change in BMD from 0-48 weeks at the L1-L4 lumbar spine, total hip, and femoral neck; absolute and percent change in weight at 48 weeks.
  
  
  RESULTS
  DMPA dose was associated with medroxyprogesterone acetate exposure as evidenced by a direct relationship (P < .001) between dose group and area under the concentration time curve. At 48 weeks, no significant BMD decreases were seen in the 75 mg dose group. The 104 and 150 mg dose groups experienced significant (P < .01) decreases in L1-L4 lumbar spine BMD (3.1% and 4.0%, respectively). The 150 mg group also had significant (P < .05) decreases in total hip (3.0%) and femoral neck (4.0%) BMD. No group differences in weight change were observed. No pregnancies occurred in any DMPA dose group.
  
  
  CONCLUSIONS
  Our data provide evidence of a dose-response relationship between DMPA and BMD loss. Intramuscular DMPA doses less than 150 mg can decrease risk of BMD loss in adolescents. The risk/benefit ratio of lower-dose DMPA should be further investigated in larger and more diverse adolescent populations.
authors: The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
authors: Hannah L H
authors: HL
authors: Lange
authors: The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
authors: Brittny E
authors: BE
authors: Manos
authors: Biostats Inc, East Canton, Ohio.
authors: M David
authors: MD
authors: Gothard
authors: The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
authors: Lynette K
authors: LK
authors: Rogers
authors: The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University, Columbus, Ohio; Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: andrea.bonny@nationwidechildrens.org.
authors: Andrea E
authors: AE
authors: Bonny
mesh_terms: D000293:Adolescent; D001835:Body Weight / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D009820:Ohio; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate
keywords: Adolescent health; Bone mineral density; Depot medroxyprogesterone acetate; Weight