The state of bone mineral density in the prolapse of the pelvic organs

Background. Plausible predictions of future mortality and disability are useful aids in making decisions about priorities for medical research. Recent advances in medicine have led to the fact that some countries, such as Japan, have the highest life expectancy in the world. Osteoporotic fractures make a significant contribution to the development of morbidity and mortality in the aging population. Despite an active study of the mechanisms of the development of pelvic organ prolapse and disorders of bone mineral density separately, the general background of these diseases has previously been little studied. Aim. To study bone density according to densitometry data in peri- and postmenopausal women. Materials and methods. To carry out this study, 2 groups of women were formed. The first (experimental) group included 76 women admitted for routine surgical treatment of genital prolapse, the second group (control) 68 women without clinical manifestations of pelvic floor descent, who underwent a medical examination by a gynecologist on an outpatient basis. Results. Analysis of extragenital diseases in women included in the study showed a high prevalence in the experimental group of hypertension (p=0.028), osteochondrosis (p=0.001), scoliosis (p=0.028), hemorrhoids (p=0.013). Also, women in this group more often noted stretch marks on the skin (p=0.002) and were more often operated on for other diseases (p=0.043), which indicates the association of genital prolapse with undifferentiated connective tissue dysplasia and hypertension. The diagnosed severe osteoporosis (according to 1 or more densitometry indicators, where the T-score is less than -2.5) had a direct correlation with the duration of menopause. For a detailed analysis of the factors influencing severe osteoporosis in peri- and postmenopausal women, logistic regression analysis and ROC analysis were performed. The independent variable was the presence of severe osteoporosis, and the dependent variables were: stage according to POP-Q, the presence of hypertension, the presence of diabetes mellitus in history. Conclusion. This study confirms the presence of a comorbidity decrease in bone density according to densitometry and the presence of hypertension (p=0.028) and genital prolapse. According to the ROC analysis, an increase in the stage of genital prolapse according to the POP-Q classification increases the risk of developing severe osteoporosis.

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ANABOLIC THERAPY AND OPTIMAL TREATMENT SEQUENCES FOR PATIENTS WITH OSTEOPOROSIS AT HIGH RISK FOR FRACTURE

Endocrine Practice ◽

10.4158/ep-2019-0596 ◽

2020 ◽

Vol 26 (7) ◽

pp. 777-786 ◽

Cited By ~ 1

Author(s):

Felicia Cosman

Keyword(s):

Bone Mineral Density ◽

High Risk ◽

Bone Density ◽

Fracture Risk ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Anabolic Agents ◽

Anabolic Therapy ◽

Fracture Study

Objective: Provide an update regarding anabolic medications for osteoporosis, which are often considered to be the last resort for patients with osteoporosis, after multiple fractures have already occurred and other medications have already been administered. Methods: Literature review and discussion. Results: Recent pivotal trial data for anabolic agents and randomized trials comparing anabolic and antiresorptive medications suggest that three anabolic agents (teriparatide, abaloparatide, and romosozumab) reduce nonvertebral and vertebral fractures faster and to a greater extent than potent antiresorptive treatments. Furthermore, bone density accrual is maximized when patients are given anabolic agents first, followed by potent antiresorptive therapy. Since total hip bone density during or after osteoporosis treatment has emerged as an excellent surrogate for future fracture risk, attaining a greater hip bone mineral density is a treatment goal for high-risk osteoporosis patients. Conclusion: This review defines the highest-risk patients and summarizes the rationale for the evolving role of anabolic therapy in the management of postmenopausal women at high risk for fracture. Abbreviations: ACTIVE = Abaloparatide Comparator Trial in Vertebral Endpoints; ARCH = Active Controlled Fracture Study in Postmenopausal Women with Osteoporosis at High Risk; BMD = bone mineral density; FRAME = Fracture Study in Postmenopausal Women with Osteoporosis; FRAX = Fracture Risk Assessment Tool; PTH = parathyroid hormone; TBS = trabecular bone score

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Relations between calcidiol serum levels and bone mineral density in postmenopausal women with low bone density

Calcified Tissue International ◽

10.1007/bf00310401 ◽

1994 ◽

Vol 55 (4) ◽

pp. 253-256 ◽

Cited By ~ 24

Author(s):

M. E. Martínez ◽

M. T. del Campo ◽

M. J. Sánchez-Cabezudo ◽

J. A. Garcia ◽

M. T. Sánchez Calvín ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Serum Levels ◽

Mineral Density ◽

Low Bone Density

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Effect of Endocrine Therapies on Bone in Breast Cancer Patients

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-1679 ◽

2011 ◽

Vol 96 (2) ◽

pp. 308-319 ◽

Cited By ~ 43

Author(s):

R. J. Santen

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Estrogen Receptor ◽

Bone Density ◽

Bone Loss ◽

Bone Formation ◽

Postmenopausal Women ◽

Bone Mineral ◽

Mineral Density ◽

Markers Of Bone Formation

abstract Context: Two common strategies are used to treat estrogen receptor-positive breast cancer in women: tamoxifen to inhibit estrogen action, and aromatase inhibitors (AIs) to block estrogen biosynthesis. Recent data suggest that AIs are more effective than tamoxifen in the adjuvant and advanced disease settings and are now being more commonly used. Tamoxifen, as a selective estrogen receptor modulator, exerts estrogenic effects to preserve bone, whereas the AIs profoundly lower estrogen levels and cause bone loss. Recent comparative studies of these agents provide extensive data on fracture rates, bone mineral density, and markers of bone formation and resorption. Objective: The aim of the study was to review the mechanistic effects of estrogen on bone and clinical data regarding bone density, bone turnover markers, and fracture rates in women with breast cancer taking tamoxifen or AIs. Evidence Acquisition and Synthesis: Data presented reflect a review of the literature and data integration from the perspective of the author's knowledge of the field. Results: Tamoxifen increases bone density and reduces fractures in postmenopausal women with breast cancer, whereas AIs increase rate of fracture, accelerate loss of bone mineral density, and enhance levels of markers of bone formation and resorption. Bisphosphonates and denosumab counteract the effects of the AIs on bone. Guidelines for management of AI-induced bone loss are available from several sources, but a simple algorithm guides decision making most effectively. Conclusions: Endocrine therapy for postmenopausal women with breast cancer exerts substantial effects on bone, and guidelines are available to assist in the management of bone-related problems.

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Effect of Endocrine Therapies on Bone in Breast Cancer Patients

Endocrinology ◽

10.1210/endo.152.1.9991 ◽

2011 ◽

Vol 152 (1) ◽

pp. 332-332

Author(s):

R. J. Santen

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Bone Density ◽

Bone Loss ◽

Bone Formation ◽

Postmenopausal Women ◽

Bone Mineral ◽

Breast Cancer Patients ◽

Mineral Density ◽

Markers Of Bone Formation

Recent data suggest that AIs are more effective than tamoxifen in the adjuvant and advanced disease settings and are now being more commonly used. Tamoxifen, as a selective estrogen receptor modulator, exerts estrogenic effects to preserve bone, whereas the AIs profoundly lower estrogen levels and cause bone loss. Recent comparative studies of these agents provide extensive data on fracture rates, bone mineral density, and markers of bone formation and resorption. Objective: The aim of the study was to review the mechanistic effects of estrogen on bone and clinical data regarding bone density, bone turnover markers, and fracture rates in women with breast cancer taking tamoxifen or AIs. Evidence Acquisition and Synthesis: Data presented reflect a review of the literature and data integration from the perspective of the author’s knowledge of the field. Results: Tamoxifen increases bone density and reduces fractures in postmenopausal women with breast cancer, whereas AIs increase rate of fracture, accelerate loss of bone mineral density, and enhance levels of markers of bone formation and resorption. Bisphosphonates and denosumab counteract the effects of the AIs on bone. Guidelines for management of AI-induced bone loss are available from several sources, but a simple algorithm guides decision making most effectively. Conclusions: Endocrine therapy for postmenopausal women with breast cancer exerts substantial effects on bone, and guidelines are available to assist in the management of bone-related problems.

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Physical activity and bone mineral density in postmenopausal women without estrogen deficiency in menstrual history

Journal of Health Sciences ◽

10.17532/jhsci.2013.108 ◽

2013 ◽

Vol 3 (3) ◽

pp. 205-209

Author(s):

Amila Kapetanović ◽

Dijana Avdić

Keyword(s):

Physical Activity ◽

Bone Mineral Density ◽

Bone Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Control Group ◽

Mineral Density ◽

Menstrual History ◽

History Of ◽

Mineral Bone Density

Introduction: The estrogen defi ciency after menopause leads to accelerated loss of bone mass. The aim of this study was to examine influence of physical activity on bone mineral density in postmenopausal women who hadn’t a deficit of estrogen in their menstrual history.Methods: This prospective study included 100 postmenopausal women, ages between 50 and 65, living in Sarajevo area without estrogen deficiency in menstrual history. The women in the examination group had osteoporosis. The women in the control group had osteopenia or normal mineral bone density. Mineral bone density was measured at the lumbar spine and proximal femur by Dual–Energy X–ray Absorptiometry using Hologic QDR-4000 scanner. To assess level of physical activity an International Physical Activity Questionnaire - Long Form was used.Results: In the examination group of women who had no history of menstrual estrogen deficit, level of physical activity was low in 52.00% female, and in 48.00% women level of physical activity was moderate. In the control group of women who had no history of menstrual estrogen defi cit in 10.00% female level of physical activity was low, and in 90.00% female level of physical activity was moderate. The difference in levels of physical activity between the two groups was statistically significant, X2 test = 20.6, p <0.005.Conclusion: Results of this study suggest that moderate physical activity has positive impact on bone mineral density in postmenopausal women without estrogen defi ciency in menstrual history and has the potential to reduce rapid bone loss after menopause.

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