148. Effect of Low-Dose Combined Oral Contraceptives on Bone Mineral Density in Adolescents: A 1-Year Follow-Up

BackgroundThe aim was to evaluate changes of bone mineral density (BMD) and markers of bone turnover in healthy adolescents, and in adolescent users of combined oral contraceptives (COCs) with different ethinylestradiol (EE) contents.MethodsIn this prospective crossover study, 56 healthy females (15–19.5 years) with desire to use hormonal contraception were randomized to COC with either 30 or 15 μg of EE in crossover design of 9-month intervention each in reverse order. Nonusers of the same age (n=28) served as controls. BMD at lumbar spine (LS), total femur, femoral neck, distal radius, and total body, and serum markers (N-propeptide of type I procollagen, and type I collagen C-telopeptide) were measured at baseline and after 9 and 18 months.ResultsIn COC nonusers, BMD significantly increased at LS and radius, while markers decreased. In COC users, BMD did not increase, with the exception of LS BMD in the 30 μg COC group (P<0.05). In the crossover design, a difference between the low- and very low-dose COC users was found in LS BMD changes (P<0.05), where increase in BMD was more impaired in the 15 μg COC users. The skeletal effects of COC remained significant after adjustments for age and smoking status. Markers declined faster in COC users during the first period, while they remained stable or even increased during the second 9 months.ConclusionPhysiological acquisition of LS BMD during adolescent age may be prevented by use of COC, especially those containing very low dose of EE.

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Bone mineral density in a cohort of adolescents during use of norethisterone enanthate, depot-medroxyprogesterone acetate or combined oral contraceptives and after discontinuation of norethisterone enanthate

Contraception ◽

10.1016/j.contraception.2008.11.009 ◽

2009 ◽

Vol 79 (5) ◽

pp. 345-349 ◽

Cited By ~ 26

Author(s):

Mags E. Beksinska ◽

Immo Kleinschmidt ◽

Jenni A. Smit ◽

Timothy M.M. Farley

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Oral Contraceptives ◽

Medroxyprogesterone Acetate ◽

Mineral Density ◽

Combined Oral Contraceptives ◽

Depot Medroxyprogesterone Acetate

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Bone mineral density at various anatomic bone sites in women receiving combined oral contraceptives and depot-medroxyprogesterone acetate for contraception

Contraception ◽

10.1016/s0010-7824(02)00308-6 ◽

2002 ◽

Vol 65 (6) ◽

pp. 407-410 ◽

Cited By ~ 43

Author(s):

P. Wanichsetakul ◽

A. Kamudhamas ◽

P. Watanaruangkovit ◽

Y. Siripakarn ◽

P. Visutakul

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Oral Contraceptives ◽

Medroxyprogesterone Acetate ◽

Mineral Density ◽

Combined Oral Contraceptives ◽

Depot Medroxyprogesterone Acetate

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Effect of Two Kinds of Different Combined Oral Contraceptives Used on Bone Mineral Density in Women of Reproductive Age

Journal of Reproduction and Contraception ◽

10.1016/s1001-7844(12)60010-8 ◽

2011 ◽

Vol 22 (3) ◽

pp. 145-151 ◽

Cited By ~ 2

Author(s):

Rui-jian LIU ◽

Ling GAI ◽

Yi-fang JIA ◽

Ping GAI ◽

Xiao-jie YU

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Oral Contraceptives ◽

Reproductive Age ◽

Mineral Density ◽

Women Of Reproductive Age ◽

Combined Oral Contraceptives

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The Effect of Low Dose Oral Vitamin D on Bone Mineral Density Changes in HIV Patients: 36 Months Follow Up

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190618160748 ◽

2020 ◽

Vol 20 (5) ◽

pp. 651-658

Author(s):

Jasreen Dhother ◽

Shyamalie Bopitiya ◽

Huda Taha ◽

Satyajit Das

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Alkaline Phosphatase ◽

Vitamin D Deficiency ◽

Bone Mineral ◽

Low Dose ◽

Mineral Density ◽

Oral Vitamin ◽

Pth Level

Background:: A high incidence of vitamin-D deficiency and abnormal bone mineral density (BMD) is reported among Human Immunodeficiency Virus (HIV) infected patients. The study highlighted the effect of oral low dose vitamin-D replacement in patients with a known vitamin- D deficiency on the levels of vitamin-D [25 (OH)D], parathyroid hormone (PTH) and Bone Mineral Density (BMD) of hip and spine. Methods:: Patients took a daily low dose of 800IU of vitamin-D. The following details were collected on all patients: demographics, CD-4 cell count, viral load, fracture risk factors, treatment history, corrected calcium, alkaline phosphatase (ALP), Parathyroid Hormone (PTH) (intact PTH), vitamin D 25(OH)D, inorganic phosphate and BMD of hip and spine at baseline, 12 and 36 months. Results:: Our Cohort consisted of 86 patients. Patient details included: mean age 42.8 (+/-7.7) years, 48 (55%) females 64, (74%) black African, CD-4 count 440.7 (+/-180.8) cells/dL, plasma VL 1.6 log (+/-2.3) copies/mL, duration of illness 80.9 (34.1) months, duration of exposure to antiretroviral 65.2 (+/-27.9) months. At baseline, no difference in BMD of hip or spine was observed, however, a higher PTH (0.001) in patients taking Tenofivir and a lower vitamin-D was noticed in patients taking Efavirenz. : After 36 months, patients on vitamin D replacement (n=44) had a significant increase in vitamin- D level (15.4 +/-10.4 vs 104.1+/-29.1 p=0.0001), lower PTH (6.3 +/-3.4 vs 4.4 +/-1.4 p=0.0001) ALP (108.9+/-78.8 vs 90.6+/-45.8 p=0.05) but no change in corrected calcium (2.13 +/-0.1 vs 2.16 +/-0.34 p=0.5) and BMD of spine (1.039+/-0.226 vs.1.027+/-0.211, p=0.77), and BMD of hip (1.020 +/- 0.205 vs. 1.039, p=0.61). In a multivariate logistic regression analysis that included all significant variables, vitamin-D replacement independently was associated with increase in vitamin- D level (OR 2.08, CI 1.03, 4.12, p=0.005), decrease in PTH level (OR 0.53, CI 0.35, 0.82, p=0.04), but not with change in corrected calcium, alkaline phosphatase, BMD of hip or spine. Conclusion:: After 36 months of follow up, the replacement of low dose once daily oral vitamin-D in the treatment experienced HIV infected patients with vitamin-D deficiency can increase vitamin- D level, reduce PTH level without any change in BMD of spine and hip.

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