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KMID : 1007020090070030168
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Korean Soceity of Osteroporosis
2009 Volume.7 No. 3 p.168 ~ p.178
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The Bone Response to Second Year Hormone Therapy according to the Basal Bone Mineral Density and the Bone Response to First Year Hormone Therapy in Korean Postmenopausal Women
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Chun Sung-Wook
Kim Hoon
Ku Seung-Yup
Suh Chang-Suk
Kim Seok-Hyun
Choi Young-Min
Moon Shin-Yong
Kim Jung-Gu
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Abstract
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Objectives: To investigate bone responses to the second year of hormone therapy (HT) according to basal bone mineral density (BMD) and responses to the first year HT in postmenopausal Korean women.
Methods: A total of 550 postmenopausal women received sequential combined estrogen-progestogen therapy for 1 year, and 318 for more than 1 year. BMD of the lumbar spine (LS), femoral neck (FN) and trochanter (FT) were measured by dual energy X-ray absorptiometry (DXA) before HT, and at 1 and 2 years after HT.
Results: Women with a greater loss of BMD during the first year of HT were more likely to gain BMD during the second year at any of the three skeletal sites. The proportion of non-responders (women with >3% bone loss per year) to HT was significantly lower in women with osteoporosis before HT compared to those with normal basal BMD during the first year of treatment, but not during the second year. The frequency of consecutive non-responders to HT was 1.9% in the LS, 2.8% FN, 2.8% FT, and 6.9% among the total group. The basal BMD at all sites and 1 -year BMD at the FT were higher in the consecutive non-responder group than in the responder group. However, there were no differences in the status of the basal and 1 -year bone mass (namely the proportion of normal BMD, osteopenia, and osteoporosis) between the two groups.
Conclusion: The higher the basal BMD was, the worse the bone response to 1 -year of HT was. However, the 2 -year HT group showed improvement. HT treatment should not be changed solely on the basis of first year BMD loss.
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KEYWORD
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Hormone therapy, Osteoporosis, Bone mineral density, Non-responder
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