Effect of Antiandrogen Treatment on Bone Density and Bone Geometry in Adolescents with Polycystic Ovary Syndrome

Bechtold, Susanne; Pozza, Robert Dalla; Putzker, Stephanie; Roeb, Julia; Buckel, Matthias; Weissenbacher, Claudia; Schmidt, Heinrich

doi:10.1016/j.jpag.2011.11.010

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…The anabolic effect of testosterone on female body composition and bone metabolism is further supported by research in women with endogenous hyperandrogenism and postmenopausal women on testosterone therapy. A higher regional muscle mass (29), higher trabecular vBMD (30,31), and aBMD at the lumbar spine (32,33) as well as larger cortical bone size (31) and aBMD at cortical sites (whole body (32,34) and femoral neck (33)) were described in women with endogenous hyperandrogenism and/or hirsutism. Similarly, exogenous testosterone added to hormonal replacement therapy in postmenopausal women resulted in higher lean body mass and muscle mass (35,36) and increased hip (35,37) and spine aBMD (35, 38) after 2 years compared with estrogen treatment alone.…”

Section: Discussionmentioning

confidence: 99%

Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case–controlled study (ENIGI)

Caenegem

Wierckx

Taes

et al. 2015

European Journal of Endocrinology

131

106

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Purpose: To assess the evolution of body composition and bone metabolism in trans men during the first year of cross-sex hormonal therapy. Methods: In a prospective controlled study, we included 23 trans men (female-to-male trans persons) and 23 age-matched control women. In both groups, we examined grip strength (hand dynamometer), biochemical markers of bone turnover (C-terminal telopeptides of type 1 collagen (CTX) and procollagen 1 aminoterminal propeptide (P1NP)), total body fat and lean mass, and areal bone mineral density (aBMD) by dual-X-ray absorptiometry (DXA) and fat and muscle area at the forearm and calf, bone geometry, and volumetric bone mineral density (vBMD) by peripheral quantitative computed tomography (pQCT), before treatment and after 1 year of treatment with undecanoate (1000 mg i.m./12 weeks). Results: Before hormonal treatment, trans men had similar bone and body composition compared with control women. Testosterone treatment induced in trans men a gain in muscle mass (C10.4%) and strength and loss of fat mass (K9.7%) (all P!0.001) and increased the levels of P1NP and CTX (both P!0.01). Areal and volumetric bone parameters remained largely unchanged apart from a small increase in trabecular vBMD at the distal radius and in BMD at the total hip in trans men (PZ0.036 and PZ0.001 respectively). None of these changes were observed in the control group. Conclusions: Short-term testosterone treatment in trans men increased muscle mass and bone turnover. The latter may rather reflect an anabolic effect of testosterone treatment rather than bone loss.

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Section: Discussionmentioning

confidence: 99%

Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case–controlled study (ENIGI)

Caenegem

Wierckx

Taes

et al. 2015

European Journal of Endocrinology

131

106

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“…A recent retrospective study of adolescents treated with metformin or metformin plus an anti-androgenic OCP and flutamide for at least 1 year found no differences between the groups with respect to BMI, abdominal fat composition, and insulin sensitivity. Similarly, there were no differences in bone density and bone geometry parameters measured using peripheral quantitative computed tomography (52). A recent small, prospective study of younger (mean age, 22 years), lean women with PCOS treated with an OCP containing ethinyl estradiol/drospirenone and SPA found a statistically significant increase in C-reactive protein and homocysteine levels after 6 months of this treatment, although there were no changes in insulin parameters or lipid profile (53).…”

Section: Are Anti-androgen Therapies Appropriate Inmentioning

confidence: 91%

American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome - Part 1

et al. 2015

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“…Metformin stimulated osteoblast proliferation in vitro and increased levels of type-I collagen and alkaline phosphatase in osteoblast-like cells (91). In adolescents, bone mineral density and bone geometry Z-scores were unchanged following 1.9 years of combined metformin/ oral contraceptive/antiandrogen or metformin treatment (92). Studies in diabetic populations suggested a minor protective effect of metformin on bone mineral density levels (91), but high glucose levels had adverse effects in bone metabolism and bone strength, leading to impaired bone quality and increased fracture risk (91).…”

Section: Bone Mineral Density and Fracturesmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

Glintborg

Andersen

2017

European Journal of Endocrinology

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Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in premenopausal women. The syndrome is characterized by hyperandrogenism, irregular menses and polycystic ovaries when other etiologies are excluded. Obesity, insulin resistance and low vitamin D levels are present in more than 50% patients with PCOS, these factors along with hyperandrogenism could have adverse effects on long-term health. Hyperinflammation and impaired epithelial function were reported to a larger extent in women with PCOS and could particularly be associated with hyperandrogenism, obesity and insulin resistance. Available data from register-based and data linkage studies support that metabolic-vascular and thyroid diseases, asthma, migraine, depression and cancer are diagnosed more frequently in PCOS, whereas fracture risk is decreased. Drug prescriptions are significantly more common in PCOS than controls within all diagnose categories including antibiotics. The causal relationship between PCOS and autoimmune disease represents an interesting new area of research. PCOS is a lifelong condition and long-term morbidity could be worsened by obesity, sedentary way of life, Western-style diet and smoking, whereas lifestyle intervention including weight loss may partly or fully resolve the symptoms of PCOS and could improve the long-term prognosis. In this review, the possible implications of increased morbidity for the clinical and biochemical evaluation of patients with PCOS at diagnosis and follow-up is further discussed along with possible modifying effects of medical treatment.

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Effect of Antiandrogen Treatment on Bone Density and Bone Geometry in Adolescents with Polycystic Ovary Syndrome

Cited by 7 publications

References 34 publications

Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case–controlled study (ENIGI)

Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case–controlled study (ENIGI)

American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome - Part 1

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

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