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Vitamin D and HRT: No benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study

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Abstract

The study was designed to examine the effect of hormone replacement therapy (HRT) and low-dose vitamin D (Vit D) supplementation on the prevention of bone loss in non-osteoporotic early postmenopausal women and to determine whether Vit D supplementation can give additional benefit to an already optimized estrogen regimen. The effects of HRT and Vit D on bone mineral density (BMD) were studied in postmenopausal women in a 2.5-year randomized placebo-controlled study. The study population was a subgroup of the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) (n=13100). A total of 464 early postmenopausal women were randomized to four groups: (1) HRT (a sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate (E2Val/CPA); (2) vitamin D3 (cholecalciferol, 300 IU/day); (3) HRT+Vit D; and (4) placebo (calcium lactate; 93 mg Ca2+/day). Lumbar (L1–4) and femoral neck BMD were determined by dual-energy X-ray absorptiometry before and after 2.5 years of treatment. After 2.5 years, lumbar BMD had increased by 1.8% in the HRT group (p<0.001) and by 1.4% in the HRT+Vit D group (p=0.002), whereas lumbar BMD had decreased by 3.5% (p<0.001) in the Vit D group and by 3.7% (p<0.001) in the placebo group. The loss of femoral neck BMD was lower in the HRT (−0.3%) and the HRT+Vit D (−0.9%) groups compared with the Vit D (−2.4%) and the placebo groups (−3.7%). This study confirms the beneficial effect of HRT on BMD. It also shows that low-dose vitamin D supplementation has only a minor effect in the prevention of osteoporosis in non-osteoporotic early postmenopausal women and does not give any benefit additional to that of HRT alone.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Kuopio University Hospital, 70210, Kuopio, Finland

    M. Komulainen MD, M. T. Tuppurainen, A. M. Heikkinen & S. Saarikoski

  2. The A.I. Virtanen Institute, University of Kuopio, Finland

    M. Komulainen MD, M. T. Tuppurainen, H. Kröger, A. M. Heikkinen, E. Puntila, E. Alhava, R. Honkanen & S. Saarikoski

  3. Department of Surgery, Kuopio University Hospital, Kuopio, Finland

    H. Kröger & E. Alhava

  4. Institute of Community Medicine, University of Tromsö, Norway

    R. Honkanen

Authors
  1. M. Komulainen MD
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  2. M. T. Tuppurainen
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  3. H. Kröger
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  4. A. M. Heikkinen
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  5. E. Puntila
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  6. E. Alhava
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  7. R. Honkanen
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  8. S. Saarikoski
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Correspondence to M. Komulainen MD.

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Komulainen, M., Tuppurainen, M.T., Kröger, H. et al. Vitamin D and HRT: No benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 7, 126–132 (1997). https://doi.org/10.1007/BF01623687

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  • DOI: https://doi.org/10.1007/BF01623687

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