Abstract
Osteoporosis is a common disorder in postmenopausal women, which is probably due to decreased ovarian function. Currently, hormone replacement therapy (HRT), involving administration of estrogen and progestogen, is successfully applied to reduce bone resorption. We studied the effect of HRT on 23 postmenopausal women. This consisted of a combination of 17β-estradiol and dydrogesterone, on the serum level of 1,25-dihydroxyvitamin D (1,25(OH)2D) after 0, 6, 12, and 24 months. We found mean serum concentrations (±SD) of 1,25(OH)2D of 130.5 pmol/liter (46.1), 152.7 pmol/liter (45.1), 170.8 pmol/liter (64.0), and 155.2 pmol/liter (59.7), respectively. The baseline values in these women were found to be significantly lower than those during therapy (P⩽0.005). No statistically significant differences were observed when comparing the estrogen-only phase with the combined estrogen-progestogen phase. It is concluded that HRT results in an increase in the serum 1,25(OH)2D concentration which lasts for at least 2 years. This increase may partly explain the preventive effect of HRT on osteoporosis. Purthermore, these results suggest that dydrogesterone does not influence the estrogen-induced changes in serum 1,25(OH)2D concentration.
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Riggs BL, Melton III LJ (1986) Involutional osteoporosis. N Engl J Med 314: 1676–1686
Albright F, Bloomberg F, Smith PH (1940) Postmenopausal osteoporosis. Tran Assoc Am Physicians 55: 298–305
Riggs BL, Hodgson SF, O'Fallon WM, Chao EYS, Wahner HW, Muhs JM, Cedel SL, Melton III LJ (1990) Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med 322: 802–809
Civitelli R, Gonnelli S, Zacchei F, Bigazzi S, Vattimo A, Avioli LV, Gennari C (1988) Bone turnover in postmenopausal osteoporosis. Effect of calcitonin treatment. J Clin Invest 82: 1268–1274
Reginster JY, Lecart MP, Deroisy R, Sarlet N, Denis D, Ethgen D, Collette J, Franchimont P (1989) Prevention of postmenopausal bone loss by tiludronate. Lancet 2: 1469–1471
Tilyard MW, Spears GFS, Thomson J, Dovey S (1992) Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 326: 357–362
Lindsay R, Hart DM, Aitken JM, MacDonald EB, Anderson JB, Clarke AC (1976) Long-term prevention of postmenopausal osteoporosis by oestrogen: evidence for an increased bone mass after delayed onset of oestrogen treatment. Lancet 1: 1038–1041
Prince RL, Smith M, Dick IM, Price RI, Webb PG, Henderson NK, Harris MM (1991) Prevention of postmenopausal osteoporosis. N Engl J Med 325: 1189–1195
Lund B, Sørensen OH, Lund B, Agner E (1982) Serum 1,25-dihydroxyvitamin D in normal subjects and in patients with postmenopausal osteopenia. Influence of age, renal function and oestrogen therapy. Horm Metabol Res 14: 271–274
Aloia JF, Vaswani A, Yeh JK, McGowan DM, Ross P (1991) Biochemical short-term changes produced by hormonal replacement therapy. J Endocrinol Invest 14: 927–934
Selby PL, Peacock M (1986) The effect of transdermal oestrogen on bone, calcium-regulating hormones and liver in postmenopausal women. Clin Endocrinol 25: 543–547
Kalu DN, Salerno E, Liu CC, Echon R, Ray M, Garza-Zapata M, Hollis BW (1991) A comparative study of the actions of tamoxifen, estrogen and progesterone in the ovariectomized rat. Bone Miner 15: 109–124
Lee JR (1991) Is natural progesterone the missing link in osteoporosis prevention and treatment. Med Hypothesis 35: 316–318
Van der Mooren MJ, Demacker PNM, Thomas CMG, Rolland R (1993) A 2-year study on the beneficial effects of 17β-oestradiol-dydrogesterone therapy on serum lipoproteins and Lp(a) in postmenopausal women: no additional unfavourable effects of dydrogesterone. Eur J Obstet Gynecol Reprod Biol 52: 117–123
Van Hoof HJC, Swinkels LMJW, van Stevenhagen JJ, van den Berg H, Ross HA, Benraad ThJ (1993) Advantages of paper chromatography as a preparative step in the assay of 1,25-dihydroxyvitamin D. J Chromatgr 621: 33–39
Bush IE (1961) The chromatography of steroids. Pergamon Press, Oxford, London, New York, Paris
Hollis BW (1986) Assay of circulating 1,25-dihydroxyvitamin D involving a novel single-cartridge extraction and purification procedure. Clin Chem 32: 2060–2063
Vecsei P, Gless KH (1975) Aldosteron-radioimmunoassay. Ferdinand Enke Verlag, Stuttgard
Healey MJR (1972) Statistical analysis of radioimmunoassay data. Biochem J 130: 207–210
Marquardt DW (1963) An algorithm for least-squares estimation of nonlinear parameters. J Soc Ind Appl Math 11: 431–441
Civitelli R, Agnusdei D, Nardi P, Zacchei F, Avioli LV, Gennari C (1988) Effects of one-year treatment with estrogens on bone mass, intestinal calcium absorbtion, and 25-hydroxyvitamin D-1α-hydroxylase reserve in postmenopausal osteoporosis. Calcif Tissue Int 42: 77–86
Bikle DD, Halloran BP, Harris ST, Portale AA (1992) Progestin antagonism of estrogen stimulated 1,25-dihydroxyvitamin D levels. J Clin Endocrinol Metab 75: 519–523
Hagenfeldt Y, Carlström K, Berlin T, Stege R (1991) Effects of orchidectomy and different modes of high dose estrogen treatment on circulating “free” and total 1,25-dihydroxyvitamin D in patients with prostatic cancer. J Steroid Biochem Mol Biol 39: 155–159
Bouillon R, Van Assche FA, Van Baelen H (1981) Influence of the vitamin D-binding protein on the serum concentration of 1,25-dihydroxyvitamin D3. J Clin Invest 67: 589–596
Cheema C, Grant BF, Marcus R (1989) Effects of estrogen on circulating “free” and total 1,25-dihydroxyvitamin D and on the parathyroid-vitamin D axis in postmenopausal women. J Clin Invest 83: 537–542
Kuhl H (1990) Pharmacokinetics of oestrogens and progestogens. Maturitas 12: 171–197
Trésmollières F, Pouilles JM, Ribot C (1993) Effect of long-term administration of progestogen on post-menopausal bone loss: result of a two-year, controlled randomized study. Clin Endocrinol 38: 627–631
Scheven BAA, Damen CA, Hamilton NJ, Verhaar HJJ, Duursma SA (1992) Stimulatory effects of estrogen and progesterone on proliferation and differentiation of normal human osteoblast-like cells in vitro. Biochem Biophys Res Comm 186: 54–60
Ishii T, Saito T, Morimoto K, Takeuchi Y, Asano S, Kumegawa M, Ogata E, Matsumoto T (1993) Estrogen stimulates the elaboration of cell/matrix surface-associated inhibitory factor of osteoclastic bone resorption from osteoblastic cells. Biochem Biophys Res Comm 191: 495–502
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van Hoof, H.J.C., van der Mooren, M.J., Swinkels, L.M.J.W. et al. Hormone replacement therapy increases serum 1,25-dihydroxyvitamin D: A 2-year prospective study. Calcif Tissue Int 55, 417–419 (1994). https://doi.org/10.1007/BF00298554
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DOI: https://doi.org/10.1007/BF00298554