Knochenstoffwechsel, Knochendichte und Östrogenspiegel in der Perimenopause: eine prospektive 2-Jahres-Untersuchung

Bone metabolism and trabecular bone density were studied prospectively in 69 pre-, peri- and early postmenopausal women. Markers of bone resorption (OC = osteocalcin, BAP = bonespecific alkalic phosphatase) and bone formation (PYD = pyridinolin, DPD = desoxypyridnolin, NTX = N-terminal telopeptide crosslinked collagen type I, CTX = C-terminal telopeptide crosslinked collagen type I) in serum and urine were followed over a course of two years with five points of examination (0, 3, 6, 12 and 24 months). Bone density was measured at 0 and 24 months. The results of 40 hormonally untreated women who completed all examinations were compared regarding menopausal status and changes over the 2-year-period. While baseline tracecular bone density was lowest in early postmenoapusal women, perimenopausal women showed greatest bone loss (- 10,6 %) during the two year study period. Bone metabolism markers were highest in the postmenopausal group. Perimenopause was associated with a gradual rise in OC, PYD and CTX. Perimenopausal women showed the highest serum estradiol at 0 and 12 months with values exceeding those of premenopausal women. Whether the increased perimenopausal bone loss could be related to the increase in anovulatory cycles during the perimenopausal transition is subject to ongoing investigation.

[1]  Nanette Santoro,et al.  Reproductive hormones in the early menopausal transition: relationship to ethnicity, body size, and menopausal status. , 2003, The Journal of clinical endocrinology and metabolism.

[2]  Sundeep Khosla,et al.  Sex steroids and the construction and conservation of the adult skeleton. , 2002, Endocrine reviews.

[3]  K. Ulm,et al.  Bone metabolism during the perimenopausal transition: a prospective study. , 2002, Maturitas.

[4]  W. Geilenkeuser,et al.  Interlaboratory variation of biochemical markers of bone turnover. , 2001, Clinical chemistry.

[5]  P. Delmas,et al.  Evaluation of a fully automated serum assay for C-terminal cross-linking telopeptide of type I collagen in osteoporosis. , 2001, Clinical chemistry.

[6]  M. Seibel,et al.  Biochemical markers to survey bone turnover. , 2001, Rheumatic diseases clinics of North America.

[7]  J. Gallagher,et al.  Role of estrogens in the management of postmenopausal bone loss. , 2001, Rheumatic diseases clinics of North America.

[8]  S. Manolagas,et al.  Birth and death of bone cells: basic regulatory mechanisms and implications for the pathogenesis and treatment of osteoporosis. , 2000, Endocrine reviews.

[9]  M. K. James,et al.  The Relationship of Biochemical Markers of Bone Turnover to Bone Density Changes in Postmenopausal Women: Results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial , 1999, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[10]  R. Parker,et al.  Early Changes in Biochemical Markers of Bone Turnover Predict the Long‐Term Response to Alendronate Therapy in Representative Elderly Women: A Randomized Clinical Trial , 1998, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[11]  J. Prior.  Perimenopause: the complex endocrinology of the menopausal transition. , 1998, Endocrine reviews.

[12]  P. Delmas,et al.  BIOCHEMICAL MARKERS OF BONE TURNOVER: Applications For Osteoporosis , 1998 .

[13]  H. Minaguchi,et al.  Specific Changes of Urinary Excretion of Cross-Linked N-Telopeptides of Type I Collagen in Pre- and Postmenopausal Women: Correlation with Other Markers of Bone Turnover , 1997, Calcified Tissue International.

[14]  J. Hopper,et al.  Bone turnover markers and bone density across the menopausal transition. , 1996, The Journal of clinical endocrinology and metabolism.

[15]  D. Eyre,et al.  Molecular basis and clinical application of biological markers of bone turnover. , 1996, Endocrine reviews.

[16]  S. Miller,et al.  Elevated progesterone during pseudopregnancy may prevent bone loss associated with low estrogen , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[17]  O. Johnell,et al.  A longitudinal study of the perimenopausal transition: altered profiles of steroid and pituitary hormones, SHBG and bone mineral density. , 1995, Maturitas.

[18]  T. Ohishi,et al.  The effect of menopause on biochemical markers and ultrasound densitometry in healthy females , 1994, Calcified Tissue International.

[19]  S. Barr,et al.  Cyclic medroxyprogesterone treatment increases bone density: a controlled trial in active women with menstrual cycle disturbances. , 1994, The American journal of medicine.

[20]  R. Eastell,et al.  Evaluation of bone turnover in type I osteoporosis using biochemical markers specific for both bone formation and bone resorption , 1993, Osteoporosis International.

[21]  R. Bartl.  Osteoporose. Prävention – Diagnostik – Therapie , 2007 .

[22]  K. Kushida,et al.  Changes in Levels of Biochemical Markers and Ultrasound Indices of Os Calcis Across the Menopausal Transition , 2000, Osteoporosis International.

[23]  J. Hopper,et al.  A Prospective Study of Bone Loss in Menopausal Australian-Born Women , 1998, Osteoporosis International.

[24]  Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin interventions (PEPI) trial. The Writing Group for the PEPI. , 1996, JAMA.

[25]  J. Winter,et al.  Pituitary-ovarian relationships preceding the menopause. I. A cross-sectional study of serum follice-stimulating hormone, luteinizing hormone, prolactin, estradiol, and progesterone levels. , 1977, American journal of obstetrics and gynecology.