Abstract
We studied bone mass and metabolism in 30 adult women (age 28.5 ± 1.3) with thalassemia major (TM) and evaluated whether prolonged hormone replacement therapy (HRT) was able to optimize bone accrual. TM patients had reduced bone mass, increased bone turnover and lower serum gonadotropin and estradiol levels compared with 10 normal women of similar age. A significant correlation was found between bone mass and sex hormone levels. Six TM patients with normal ovarian function had normal bone turnover markers and modestly low bone mass (lumbar spine −1.29 ± 0.31; femoral neck −0.60±0.21; Z-score). The other 24 TM women were hypogonadic and had significantly lower bone mass for age (lumbar spine −2.35 ± 0.2, femoral neck −1.83 ± 0.2) and increased bone turnover relative to eugonadal women. Of the hypogonadal patients, 13 had taken HRT since age 15 ± 1 years, but their bone mass and turnover markers were not different than untreated hypogonadal patients. In conclusion, while hypogonadism negatively affects bone mass acquisition in adult TM women, HRT at the standard replacement doses is not sufficient to secure optimal bone accrual.
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R Orvieto I Leichter A Rachmilewitz JY Margulies (1992) ArticleTitleBone density, mineral content, and cortical index in patients with thalassemia major and the correlation to their bone fractures, blood transfusions, and treatment with desferrioxamine. Calcif Tissue Int 50 397–399 Occurrence Handle1:STN:280:By2B1c3ksFM%3D Occurrence Handle1596775
CE Jensen SM Tuck JE Agnew S Koneru RW Morris A Yardumian E Prescott AV Hoffbrand B Wonke (1998) ArticleTitleHigh prevalence of low bone mass in thalassemia major. Br J Haematol 103 901–915 Occurrence Handle10.1046/j.1365-2141.1998.01108.x
E Voskaridou MC Kyrtsonis E Terpos M Skordili I Theodoropoulos A Bergele E Diamanti A Kalovidouris A Loutradi D Loukopoulos (2001) ArticleTitleBone resorption is increased in young adults with thalassemia major. Br J Haematol 112 36–41 Occurrence Handle10.1046/j.1365-2141.2001.02549.x Occurrence Handle1:STN:280:DC%2BD3M7ltFaksw%3D%3D Occurrence Handle11167780
C Wang SC Tso D Todd (1989) ArticleTitleHypogonadotropic hypogonadism in severe thalassemia: effect of chelation and pulsatile gonadotropin-releasing hormone therapy. J Clin Endocrinol Metab 68 511 Occurrence Handle1:STN:280:BiaC3sbns1I%3D Occurrence Handle2493034
ML Anapliotou IT Kastanias P Psara EA Evangelou M Lipakari P Dimitriou (1995) ArticleTitleThe contribution of hypogonadism to the development of osteoporosis in thalassemia major: new therapeutic approaches. Clin Endocrinol 42 279–287 Occurrence Handle1:STN:280:ByqB2sjpvVU%3D
A Lasco N Morabito A Gaudio M Bruno M Wasniewska N Frisina (2001) ArticleTitleEffects of hormonal replacement therapy on bone metabolism in young adults with beta-thalassemia major. Osteoporos Int 12 570–575 Occurrence Handle10.1007/s001980170079 Occurrence Handle1:CAS:528:DC%2BD3MXns1yqtLk%3D Occurrence Handle11527055
AT Soliman N El Banna M Abdel Fattah MM El Zalabani BM Ansari (1998) ArticleTitleBone mineral density in prepubertal children with beta-thalassemia: correlation with growth and hormonal data. Metabolism 47 541–548 Occurrence Handle1:CAS:528:DyaK1cXjtFertLw%3D Occurrence Handle9591744
PJ Giardina R Schneider M Lesser B Simmons A Rodriguez J Gertner M New MW Hillgartner (1995) Abnormal bone metabolism in thalassemia. S Ando (Eds) Endocrine disorders in thalassemia. Springer, Berlin, 39
FZ Stanczyk L Chang E Carmina Z Putz RA Lobo (1991) ArticleTitleIs 11 hydroxyandrostenedione a better marker of adrenal androgen excess than dehydroepiandrosterone sulfate? Am J Obstet Gynecol 166 1837–1842
E Carmina M Ferin RA Lobo (1999) ArticleTitleEvidence that insulin and androgens may participate in the regulation of serum leptin levels. Fertil Steril 72 426–431 Occurrence Handle10.1016/S0015-0282(99)00387-8
AK Sugimoto AB Hodsman JA Nisker (1993) ArticleTitleLong-term gonadotropin releasing hormone agonist with standard postmenopausal estrogen replacement failed to prevent vertebral bone loss in premenopausal women. Fertil Steril 60 672–674 Occurrence Handle1:STN:280:ByuD3cbnslU%3D Occurrence Handle8405523
E Carmina RA Lobo (1996) Steroid supplementation of GnRH analog in ovarian hyperandrogenism. M Filicori C Flamigni (Eds) Treatment with GnRH analogs: controversies and perspectives. Parthenon Pub. London, 115–121
C Wang SC Tso D Todd (1989) ArticleTitleHypogonadotropic hypogonadism in severe beta thalassemia: effect of chelation and pulsatile gonadotropin-realising hormone therapy. J Clin Endocrinol Metab 68 511 Occurrence Handle1:STN:280:BiaC3sbns1I%3D Occurrence Handle2493034
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Carmina, E., Di Fede, G., Napoli, N. et al. Hypogonadism and Hormone Replacement Therapy on Bone Mass of Adult Women with Thalassemia Major . Calcif Tissue Int 74, 68–71 (2004). https://doi.org/10.1007/s00223-002-1044-3
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DOI: https://doi.org/10.1007/s00223-002-1044-3