Osteoporosis in premenopausal women
Authors:
Juraj Payer; Juraj Smaha; Martin Kužma; Zdenko Killinger; Peter Jackuliak
Authors‘ workplace:
V. interná klinika Lekárskej fakulty UK a Univerzitnej nemocnice Bratislava
Published in:
Vnitř Lék 2021; 67(5): 284-290
Category:
Main Topic
Overview
In contrast to postmenopausal women diagnostic process and treatment of premenopausal osteoporosis in young women reamin poorly defined. A low bone mineral density in premenopausal women is not associated with the same risk of fractures as in postmenopausal women, therefore diagnosis requires not only densitometric examination but depends on the consideration of other risk factors. Most cases of premenopausal osteoporosis are associated with chronic diseases affecting bone metabolism. Treatment of the underlying disease may improve bone density as well as bone quality. Rarely, a bone-specific antiporotic therapy may be used, although quality evidence is scarce. This article will review current opinion on definition, diagnosis and treatment of premenopausal osteoporosis.
Keywords:
premenopausal osteoporosis – risk of fracture – densitometry – treatment
Sources
1. Kanis JA et al. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporosis International, 2020; 31(1): p. 1–12.
2. Rozenberg S et al. How to manage osteoporosis before the age of 50. Maturitas, 2020; 138: p. 14–25.
3. Khan AA, Syed Z. Bone densitometry in premenopausal women: synthesis and review. J Clin Densitom, 2004; 7(1): p. 85–92.
4. Liu JM et al. IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women. J Bone Miner Metab, 2008; 26(2): p. 159–164.
5. Cramarossa G. et al. Prevalence and associated factors of low bone mass in adults with systemic lupus erythematosus. Lupus, 2017; 26(4): p. 365–372.
6. Sharma M, et al. Lean Mass and Disease Activity are the Best Predictors of Bone Mineral Loss in the Premenopausal Women with Rheumatoid Arthritis. Indian J Endocrinol Metab, 2018; 22(2): p. 236–243.
7. Rahaman SH et al. Bone Health in Patients with Cushing’s Syndrome. Indian J Endocrinol Metab, 2018; 22(6): p. 766–769.
8. Dutta D et al. Occurrence & predictors of osteoporosis & impact of body composition alterations on bone mineral health in asymptomatic pre-menopausal women with HIV infection. The Indian journal of medical research, 2018; 147(5): p. 484–495.
9. Cairoli E et al. Bone involvement in young adults with cystic fibrosis awaiting lung transplantation for end-stage respiratory failure. Osteoporos Int, 2019. 30(6): p. 1255–1263.
10. Martínez-Morillo MD. Grados, and S. Holgado, Premenopausal Osteoporosis: How to Treat? Reumatología Clínica (English Edition), 2012; 8(2): p. 93–97.
11. Weaver CM et al. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int, 2016; 27(4): p. 1281–1386.
12. Schousboe JT et al. Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom, 2013; 16(4): p. 455–466.
13. Shepherd JA et al. Executive Summary of the 2015 ISCD Position Development Conference on Advanced Measures From DXA and QCT: Fracture Prediction Beyond BMD. J Clin Densitom, 2015; 18(3): p. 274–286.
14. Greendale GA et al. Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women’s Health Across the Nation (SWAN). J Bone Miner Res, 2012; 27(1): p. 111–118.
15. Ferrari S et al. Osteoporosis in young adults: pathophysiology, diagnosis, and management. Osteoporos Int, 2012; 23(12): p. 2735–2748.
16. Lewiecki EM et al. Proceedings of the 2016 Santa Fe Bone Symposium: New Concepts in the Management of Osteoporosis and Metabolic Bone Diseases. Journal of Clinical Densitometry, 2017; 20(2): p. 134–152.
17. Lewiecki EM et al. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone, 2008; 43(6): p. 1115–1121.
18. Buckley L et al. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Rheumatol, 2017; 69(8): p. 1521–1537.
19. Ferrari SL et al. Childhood fractures are associated with decreased bone mass gain during puberty: an early marker of persistent bone fragility? J Bone Miner Res, 2006; 21(4): p. 501–507.
20. Greendale GA et al. Premenopausal and early postmenopausal trabecular bone score (TBS) and fracture risk: Study of Women’s Health Across the Nation (SWAN). Bone, 2020; 140: p. 115543.
21. Kužma M et al. High Serum Fractalkine is Associated with Lower Trabecular Bone Score in Premenopausal Women with Graves’ Disease. Horm Metab Res, 2018; 50(8): p. 609–614.
22. Jackuliak P et al. Good long-term glycemic compensation is associated with better trabecular bone score in postmenopausal women with type 2 diabetes. Physiol Res, 2019; 68(Suppl 2): p. S149–s156.
23. Ross AC et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol M et al. Effects of the bisphosphonate, alendronate, on parturition in the rat. Toxicol Appl Pharmacol, 1993; 121(2): p. 217–223.
24. Sokal A et al. Pregnancy and newborn outcomes after exposure to bisphosphonates: a case-control study. Osteoporos Int, 2019; 30(1): p. 221–229.
25. Cohen A, Shane E. Evaluation and management of the premenopausal woman with low BMD. Current osteoporosis reports, 2013; 11(4): p. 276–285.
26. Fink HA et al. Long-Term Drug Therapy and Drug Discontinuations and Holidays for Osteoporosis Fracture Prevention: A Systematic Review. Ann Intern Med, 2019; 171(1): p. 37–50.
27. Wotton CJ et al. Use of oral bisphosphonates and risk of hospital admission with osteonecrosis of the jaw: Large prospective cohort study in UK women. Bone, 2019. 124: p. 69–74.
28. Wood J et al. Novel antiangiogenic effects of the bisphosphonate compound zoledronic acid. J Pharmacol Exp Ther, 2002; 302(3): p. 1055–1061.
29. Taxel P et al. Cancer Treatment-Induced Bone Loss in Women With Breast Cancer and Men With Prostate Cancer. Journal of the Endocrine Society, 2018; 2(7): p. 574–588.
30. Gnant M et al. Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 62-month follow-up from the ABCSG-12 randomised trial. Lancet Oncol, 2011; 12(7): p. 631–641.
31. Hershman DL et al. Prevention of bone loss by zoledronic acid in premenopausal women undergoing adjuvant chemotherapy persist up to one year following discontinuing treatment. J Clin Endocrinol Metab, 2010; 95(2): p. 559–566.
32. Delmas PD et al. Bisphosphonate risedronate prevents bone loss in women with artificial menopause due to chemotherapy of breast cancer: a double-blind, placebo-controlled study. J Clin Oncol, 1997; 15(3): p. 955–962.
33. Hines SL et al. Phase III randomized, placebo-controlled, double-blind trial of risedronate for the prevention of bone loss in premenopausal women undergoing chemotherapy for primary breast cancer. J Clin Oncol, 2009; 27(7): p. 1047–1053.
34. Bone HG et al. Effects of Denosumab on Bone Mineral Density and Bone Turnover in Postmenopausal Women. The Journal of Clinical Endocrinology & Metabolism, 2008; 93(6): p. 2149–2157.
35. Finkelstein JS et al. Prevention of estrogen deficiency-related bone loss with human parathyroid hormone-(1-34): a randomized controlled trial. Jama, 1998; 280(12): p. 1067–1073.
36. Cohen A et al. Teriparatide for idiopathic osteoporosis in premenopausal women: a pilot study. J Clin Endocrinol Metab, 2013; 98(5): p. 1971–1981.
37. Choe EY et al. Effect of teriparatide on pregnancy and lactation-associated osteoporosis with multiple vertebral fractures. J Bone Miner Metab, 2012; 30(5): p. 596–601.
38. Langdahl BL et al. Teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: an analysis by gender and menopausal status. Osteoporos Int, 2009; 20(12): p. 2095–2104.
39. Curtis JR et al. Population-based assessment of adverse events associated with long- -term glucocorticoid use. Arthritis Rheum, 2006; 55(3): p. 420–426.
40. Rizzoli R, Biver E. Glucocorticoid-induced osteoporosis: who to treat with what agent? Nat Rev Rheumatol, 2015; 11(2): p. 98–109.
41. Payer J, Brazdilova K, Jackuliak P. Management of glucocorticoid-induced osteoporosis: prevalence, and emerging treatment options. Drug Healthc Patient Saf, 2010; 2: p. 49–59.
42. Van Staa TP et al. Use of oral corticosteroids and risk of fractures. J Bone Miner Res, 2000; 15(6): p. 993–1000.
43. Miller KK et al. Determinants of skeletal loss and recovery in anorexia nervosa. J Clin Endocrinol Metab, 2006; 91(8): p. 2931–2937.
44. Tichá Ľ et al. Porucha kostného metabolizmu pri mentálnej anorexii Čes-slov Pediat., 2016; 71(5–6): p. 287–292.
45. Sim LA et al. Effect on bone health of estrogen preparations in premenopausal women with anorexia nervosa: a systematic review and meta-analyses. Int J Eat Disord, 2010; 43(3): p. 218–225.
46. Baqi L et al. Thyrotropin versus thyroid hormone in regulating bone density and turnover in premenopausal women. Endocr Regul, 2010; 44(2): p. 57–63.
47. Kuzma M, Payer J. (Growth hormone deficiency, its influence on bone mineral density and risk of osteoporotic fractures). Cas Lek Cesk, 2010; 149(5): p. 211–216.
48. Kužma M et al. (Issues related to secondary osteoporosis associated with growth hormone deficiency in adulthood). Vnitr Lek, 2017; 63(10): p. 658–661.
49. Kužma M et al. Impact of the growth hormone replacement on bone status in growth hormone deficient adults. Growth Horm IGF Res, 2014; 24(1): p. 22–28.
50. Kužma M et al. Kvalita kosti u akromegalikov. Vnitřní lékařství, 2017; 63(9): p. 589–592.
51. Kužma M et al. Trabecular Bone Score Change Differs with Regard to 25(OH)D Levels in Patients Treated for Adult-Onset Growth Hormone Deficiency. Endocrine Practice, 2016; 22(8): p. 951–958.
52. Kužma M et al. Non-invasive DXA-derived bone structure assessment of acromegaly patients: a cross-sectional study. Eur J Endocrinol, 2019; 180(3): p. 201–211.
53. World Health, O., Guideline: calcium supplementation in pregnant women. 2013, Geneva: World Health Organization.
54. Holick MF et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 2011; 96(7): p. 1911–1930.
55. Kalkwarf HJ et al. The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med, 1997; 337(8): p. 523–528.
56. Scioscia MF et al. Severe Bone Microarchitecture Impairment in Women With Pregnancy and Lactation-Associated Osteoporosis. J Endocr Soc, 2021; 5(5): p. bvab031.
57. O’Sullivan SM et al. Bisphosphonates in pregnancy and lactation-associated osteoporosis. Osteoporos Int, 2006; 17(7): p. 1008–1012.
58. Cerit ET, Cerit M. A case of pregnancy and lactation associated osteoporosis in the third pregnancy; robust response to teriparatide despite delayed administration. Bone reports, 2020; 13: p. 100706–100706.
59. Recker RR et al. Bone gain in young adult women. Jama, 1992; 268(17): p. 2403–2408.
60. Peris P et al. Bone mineral density evolution in young premenopausal women with idiopathic osteoporosis. Clin Rheumatol, 2007; 26(6): p. 958–961.
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2021 Issue 5
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