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T Naessén

Publications and source records attributed to T Naessén.

At least 19 recordsLinked to original sources
PubMed2002

Ambulatory morning growth hormone concentrations increase in men and decrease in women with age.

A remarkable 80-fold difference in median growth hormone (GH) values in young adult men and women was recently found in a study of sera taken in ambulatory state in the morning, after overnight fasting. In this study, the effect of ageing on morning ambulatory GH levels was investigated in 254 apparently healthy men, 21-75 years of age, and 40 women, 21-85 years. Furthermore, the effect of oestradiol on morning GH values was studied in 19 postmenopausal women, 51-79 years, treated with subcutaneous implants of 17beta-oestradiol (E2). The sera were analysed for GH, sex hormone-binding globulin (SHBG), E2, and in the men, also for testosterone (T). The morning GH levels increased (p<0.0001) with age in a group of 195 men of 41-75 years. After adjustment for age, an inverse correlation (p <0.05) was found between the levels of GH and free androgen index (T/SHBG) and a direct correlation between GH and SHBG. These relationships were more pronounced before the age of 60 than after. In the women, the GH levels decreased (p<0.01) with age and the gender difference of median values was reduced from 102-fold at younger age, 21-39 years, to 12-fold in elderly individuals, 60-75 years. In the E2-treated postmenopausal women, the morning GH values were similar to those of an untreated control group, indicating that the decrease with age in the morning GH levels in women is not a result of lower oestrogen levels alone. The gender difference in median ambulatory morning GH values decreased from 102-fold at a mean age of 25 years to 12-fold at a mean age of 68 years owing to opposite changes with age in men and women: an increase in men and a decrease in women.

Adult↗
PubMed2002

Lipids and antioxidative effects of estradiol and sequential norethisterone acetate treatment in a 3-month randomized controlled trial.

OBJECTIVE: To determine the influence of hormone replacement therapy on serum lipids and antioxidative factors associated with the risk of coronary heart disease. METHODS: The effect of a sequential estradiol-norethisterone acetate regimen or placebo on lipid metabolism, antioxidative variables and fatty acid composition in serum was measured during the peak-estrogen phase in a randomized, double-blind, placebo-controlled study of 42 healthy postmenopausal women for 3 months. RESULTS: Active treatment significantly reduced lipoprotein(a) by 15% (p = 0.005, compared with placebo), low-density lipoprotein (LDL) cholesterol by 10% (p = 0.005) and the LDL cholesterol/high-density lipoprotein (HDL) cholesterol ratio by 11% (p = 0.016). Serum triglycerides increased by 21% (p = 0.045). No effect was observed on HDL cholesterol, on apolipoproteins apo A(1) or apo B, or on non-esterified fatty acids in serum. No treatment effect was seen in the proportions of monounsaturated and polyunsaturated fatty acids. The concentration of malondialdehyde in serum did not change with the estrogen-progestin treatment. CONCLUSIONS: This sequential estrogen-progestin therapy has a beneficial effect on apolipoprotein(a) and LDL cholesterol, but no effect on non-esterified fatty acids or the level of lipid peroxidation products in serum.

Administration, Oral↗
PubMed2001

Compounds with affinity for serotonergic receptors in the treatment of premenstrual dysphoria: a comparison of buspirone, nefazodone and placebo.

RATIONALE: It is well established that serotonin reuptake inhibitors (SRIs) are effective for the treatment of premenstrual dysphoria (PMD), but the receptor subtype(s) mediating this effect of serotonin have yet not been identified. OBJECTIVE: In this trial, the possible efficacy of buspirone, a partial 5HT1A receptor agonist, and nefazodone, a combined SRI and 5HT2 receptor antagonist, was evaluated in women with PMD. METHODS: After a three-menstrual-cycle screening phase, patients were randomised to buspirone (n=19), nefazodone (n=22) or placebo (n=22). During the first two treatment cycles, patients were taking the drug during the luteal phase only (mean +/- SD daily dose of buspirone: 21 +/- 6 mg; nefazodone: 228 +/- 54 mg). During the subsequent two cycles, the medication was taken each day of the menstrual cycle (mean daily dose of buspirone: 27 +/- 10 mg; nefazodone: 304 +/- 95 mg). RESULTS: With respect to self-rated global improvement, buspirone (P<0.001) but not nefazodone was significantly superior to placebo. While buspirone appeared to reduce self-rated irritability (visual analogue scale) more effectively than placebo, other self-rated symptoms did not differ markedly between the groups. The side-effects were mild, and sexual dysfunction was not significantly more common in patients given buspirone or nefazodone than in those given placebo. CONCLUSION: It is suggested that buspirone is mildly effective for premenstrual irritability. In patients experiencing sexual dysfunction when treated with an SRI, buspirone may be a useful alternative.

Adult↗
PubMed2000

Risk of myocardial infarction after oophorectomy and hysterectomy.

To determine the risk of developing a first myocardial infarction after a hysterectomy and/or oophorectomy. Case-cohort analysis performed among 17,126 women in the Uppsala Health Care Region of Sweden, who had undergone a hysterectomy and/or oophorectomy in 1965 to 1983. Record linkage was used for follow-up and medical records to ascertain the actual history of oophorectomy. Risk estimates were calculated by relating the observed number of cases in the cohort to that expected on the basis of incidence rates in the population. Overall, 214 cases of myocardial infarction were observed. In premenopausal women a bilateral oophorectomy alone tended to increase the relative risk 1.6; 95% CI 0.8-3.1, but this operation combined with hysterectomy increased the risk only among those aged 50 and over at surgery. Hysterectomy at premenopausal age or unilateral oophorectomy did not alter the risk of myocardial infarction. In naturally menopausal women, hysterectomy-mainly for uterine myoma-was associated with a four-fold increase in relative risk (3.8; 95% CI 1.9-7.8). Hysterectomy for treatment of myoma performed after a natural menopause is linked to an excess risk for myocardial infarction. Bilateral oophorectomy before menopause may increase the risk of myocardial infarction.

Adult↗
PubMed1999

Performance in functional balance tests during menopausal hormone replacement: a double-blind placebo-controlled study.

BACKGROUND AND PURPOSE: Recent studies have indicated that oestrogens might have an effect on postural control. The purpose of this study was to investigate the short-term effect of hormone replacement therapy (HRT) on postural control in menopausal women and to analyse the correlation between sway velocity measures and results of functional balance tests. SUBJECTS: 100 menopausal women who were randomized to receive either HRT or placebo for three months were included in the study. METHOD: The balance function was measured with nine different static and dynamic functional balance tests. The sway velocities were measured on a computerized force platform. RESULTS: No significant differences were found between the two groups in the results of the functional balance tests after the three-month placebo-controlled period or in the changes over time. However, some significant improvements occurred within both groups over this three-month period. The correlations between different sway velocities and the results of the functional balance tests were all very low (r < 0.35). CONCLUSION: It can not be concluded that HRT had a positive effect on the performance in the functional balance tests, as some improvement occurred in both groups. The low correlations indicate that the sway velocity and functional balance tests measure different aspects of balance function.

Analysis of Variance↗
PubMed1999

Pregnancy-related back and pelvic pain and changes in bone density.

OBJECTIVE: To elucidate whether there is an association between pregnancy-related back and pelvic pain and changes in bone density. METHODS: In this prospective cohort study, bone density was measured in the distal and ultra-distal forearm at 12 and 35 weeks of pregnancy and at 5 months post partum. The location and degree of any back or pelvic pain was registered. The patients were classified into four subgroups on the basis of presence or absence of disabling pain in late pregnancy and presence or absence of pain at 5 months' follow-up. Forty-nine women participated. RESULTS: Bone density decreases during pregnancy and lactation. Trabecular bone is mainly lost during pregnancy and cortical bone during lactation. No association between back or pelvic pain during pregnancy and bone loss was found. Between 35 weeks of pregnancy and 5 months post partum, bone loss in all the women was estimated as 1.1% of cortical bone (p < 0.001) and 0.6% of trabecular bone (n.s.). During the same period five women with mild pain during pregnancy and pain at follow-up lost 3.9% of cortical bone (p=0.043) and 5.3% of trabecular bone (p=0.043). Although this bone loss was significant compared to the other subgroups, the small study size does not permit general conclusions to be drawn from this finding. CONCLUSION: The results indicate that bone density decreases during pregnancy and lactation. The decrease in bone density was not associated with back or pelvic pain during pregnancy. It remains unclear whether bone loss is associated with back and pelvic pain during lactation.

Absorptiometry, Photon↗
PubMed1996

Time-related effects of a progestogen on the isoforms of serum gonadotrophins in 17 beta-oestradiol treated post-menopausal women.

OBJECTIVE: It has previously been shown that 17 beta-oestradiol (E2) implants counteract the formation of more acidic isoforms of the gonadotrophins in post-menopausal women. A much lesser effect was observed on the charge of the gonadotrophin isoforms in women with chronic oral daily therapy with 2 mg E2 combined with a progestogen, 1 mg norethisterone acetate (NETA), in spite of similar serum levels of E2 and SHBG. The presence of the progestogen in the latter study may explain the difference observed. The present study investigated the effect of the progestogen NETA on the charge and concentration of serum FSH and LH in E2 implant treated women. DESIGN: A group of 8 post-menopausal women, mean age 65 years (range 50-80 years) treated with 20 mg E2 implants every 6 months, participated in the study. The women were given a daily oral medication of 5 mg NETA for a 4-week period starting at 4 weeks after the insertion of an E2 implant (mean serum E2 420 pmol/l). This treatment with NETA was repeated in 6 of the women starting at 18 weeks after the insertion of the E2 implant (mean serum E2 317 pmol/l). Blood samples were obtained at the start of the NETA therapy, after 2 and 4 weeks of treatment and at 4 weeks after the last NETA treatment. The effects of NETA therapy on the charge of the serum gonadotrophin isoforms was determined by electrophoresis in 0.1% agarose suspension and FSH, LH, E2, and SHBG were determined with fluoroimmunoassays. RESULTS: The NETA treatment decreased the serum FSH and LH levels after 2 weeks to 24 and 23% of the levels before NETA and after 4 weeks to 14.6 and 8.8%, which were 1.3 and 2.2% of the mean levels for non-treated post-menopausal women. Both FSH and LH isoforms became more acidic during the first 2 weeks of treatment. During the following 2 weeks of NETA treatment the isoforms of both FSH and LH became more basic again. Ten weeks later both the concentration and the charge of the gonadotrophins were similar to those before the NETA treatment. The changes in concentration and charge of the gonadotrophins during the second treatment period were similar to those during the first. All the changes were statistically significant (P < 0.05 - < 0.001). The mean SHBG level decreased (P < 0.01) from 84.5 to 70.6 nmol/l after 2 weeks and to 59.9 nmol/l after 4 weeks of NETA treatment and increased (P < 0.01) 10 weeks later to 77 nmol/l. CONCLUSION: In the oestradiol treated women, the effect of the progestogen norethisterone acetate on the charge of the gonadotrophin isoforms was time-related. The oestradiol effect on the charge was counteracted during the first 2 weeks of progestogen treatment and more acidic isoforms appeared in the circulation. During the following 2 weeks the isoforms became more basic again. The levels of the gonadotrophins were efficiently decreased after 2 weeks of progestogen treatment and further decreased after 4 weeks. The time-related effect of the progestogen on the gonadotrophin isoforms may be mediated via changes in the pattern of GnRH release from the hypothalamus. The observed gradual decrease in the SHBG level during the progestogen therapy may cause an increased oestradiol effect on the hypothalamus and pituitary.

Administration, Oral↗
PubMed1996

Long-term trends in incidence of and mortality from acute myocardial infarction and stroke in women: Analyses of total first events and of deaths in the Uppsala Health Care Region, Sweden.

We studied the trends from 1969 to the mid-1980s in the incidence and mortality of acute myocardial infarction and stroke in Swedish women residing in the Uppsala Health Care Region. We used data from the Inpatient Care and Causes of Death registers to obtain total first event incidence and mortality rates. In our population, there were 20,182 acute myocardial infarctions and 30,462 stroke events, and 17,359 and 21,336 deaths, respectively. We found an average overall annual increase of 1.3% in the age-standardized incidence of acute myocardial infarction during the 1970s, followed by decreasing rates during the early 1980s. Mortality was virtually unchanged. Notably, among women 45-49 years of age, we observed a rising trend during the whole period, whereas in the oldest age groups, the increase slowed and reversed in the latter years. Both the incidence and mortality for stroke declined steadily: the age-standardized incidence fell by an average of 2.1% per year for all stroke and 7.8% for intracerebral hemorrhage. The falling rate of stroke was best explained by birth cohort effects, with a 30% reduction in women born in 1920 and later as compared with those born in 1890. We conclude that important changes in Swedish women's cardiovascular health have taken place and that increasing cigarette smoking and hypertensive treatment are major determinants.

Adult↗
PubMed1995

Heel ultrasound in women after long-term ERT compared with bone densities in the forearm, spine and hip.

To compare heel ultrasound values with bone densities at different measurement sites as determined by single photon absorptiometry (SPA) and dual-energy X-ray absorptiometry (DXA) in long-term users of estrogen replacement therapy (ERT), we analyzed data from 30 users of estradiol implants (mean duration of treatment 16 years) and 32 non-users, comprising 28 complete age-matched pairs. The precision errors in vivo of ultrasound measurements were 0.18%, 1.3% and 1.5% for speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index, respectively. In the controls, ultrasound parameters correlated well with values from SPA and DXA measurements (r = 0.51-0.63, p < 0.004). In long-term users of ERT, however, measurements with ultrasound did not correlate with DXA in the spine and hip (r = 0.01-0.31, NS) but correlated well with SPA in the forearm (r = 0.47-0.66, p < 0.009). Implant users, compared with non-users, had small and just significantly different values when measured by ultrasound (at most 12%, p = 0.03-0.04) but significantly higher bone mineral densities (18%-25%, p = 0.0001-0.01) in the forearm, spine and hip when measured by SPA or DXA. Data indicated that a substantial proportion of long-term users of estrogen may be non-responders concerning the effect of estrogen on bone qualities expressed in heel ultrasound values. In a multivariate regression analysis the effect of increasing age and increasing treatment duration were both negative for the ultrasound parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1995

Effect of chronic daily oral administration of 17 beta-oestradiol and norethisterone on the isoforms of serum gonadotrophins in post-menopausal women.

OBJECTIVE: Chronic treatment with 17 beta-oestradiol (E2) implants has been found to counteract the formation of more acidic isoforms of the gonadotrophins in post-menopausal women. Oral medication with an oestrogen in combination with a progestagen is a common hormone replacement therapy (HRT) in post-menopausal women. The present study investigated the effect of such a therapy on the concentration and charge of the gonadotrophin isoforms in serum. DESIGN: Serum samples were obtained from 20 post-menopausal women, mean age 60 years (range 50-72 years), treated with continuous daily oral medication of 2 mg E2 combined with 1 mg norethisterone acetate (NETA). FSH, LH and E2 in the serum was measured with fluoroimmunoassays. The median charge and charge heterogeneity of the FSH and LH isoforms were determined for each serum by electrophoresis in 0.1% agarose suspension. Sera from 20 post-menopausal women without a history of HRT served as controls. The results were compared with those from previous studies on post-menopausal women treated with E2 implants and on women with normal menstrual cycles. RESULTS: The E2 level in the oral-E2 + NETA treated women was 198-610 pmol/l, within the range expected during the mid-luteal phase of the normal menstrual cycle and similar to that of the group of women with an E2 implant. The mean LH level was similar to that of the luteal phase of the cycle and significantly lower than that of the controls (P < 0.001), the E2 implant group (P < 0.001) and at the follicular phase of the cycle (P < 0.01). The mean FSH level was similar to that of the follicular phase and the E2 implant group but lower than that of the controls (P < 0.001) and higher than at the luteal phase of the cycle (P < 0.01). The mean values for median charge of both FSH and LH were less acidic than those of the controls (P < 0.001) but more acidic than those for the E2 implant group (P < 0.01; P < 0.001) and for different phases of the menstrual cycle (P < 0.05; P < 0.001). The mean degree of charge heterogeneity of FSH was larger (P < 0.01), while that of LH was smaller (P < 0.01), than for the controls. The mean concentrations of SHBG in the oral E2 + NETA group, the E2 implant group and the controls were similar. CONCLUSION: Chronic oral therapy with 2 mg 17 beta-oestradiol combined with 1 mg norethisterone in post-menopausal women efficiently decreased the serum gonadotrophin levels but only partly counteracted the formation of the more acidic isoforms of FSH and LH after menopause. The differences in the charge for both FSH and LH between the E2 implant and the oral E2 + NETA treated groups may be due to the differences in route of administration of E2 or to the effect of norethisterone or both.

Aged↗
PubMed1995

Validity of information on gynecological operations in the Swedish in-patient registry.

In order to validate information held at the Swedish In-patient Registry on oophorectomy and/or hysterectomy procedures, the register codes were compared with data from the medical records in a random sample of 1,338 women. Only 1% of these codes were missing but 5% were erroneous, which in most cases meant that the oophorectomy had been misclassified. The positive predictive value of operation codes was high, ranging from 86 to 100% of the registered events. The actual procedures among women registered with a code for hysterectomy with or without oophorectomy comprised hysterectomy alone in 47% of the women and hysterectomy with a bilateral or unilateral oophorectomy in 30% and 20%, respectively. The reliability of register codes for major gynecological surgical procedures is good, but when the code for hysterectomy is used, medical record data are needed to ascertain the ovarian status. Revised codes are therefore recommended.

Adult↗
PubMed1994

Reduced risk of breast and endometrial cancer among women with hip fractures (Sweden).

To test the hypothesis that osteoporosis, which results partly from long-term estrogen deficiency, is associated with a lowered risk of breast and endometrial cancer, a population-based cohort study was performed in Sweden. Some 18,000 women were followed through record-linkages after a first hip fracture, on average for almost six years, to ascertain the incidence of breast and endometrial cancer. Expected numbers were derived from the general population. Overall, 253 cases of breast cancer were observed cf 300 expected (standardized incidence ratio [SIR] = 0.84; 95 percent confidence interval [CI] = 0.74-0.95). Forty-eight cases of endometrial cancer were found cf 55 expected (SIR = 0.87, CI = 0.54-1.16). There was no clearcut pattern of breast cancer risk by age at diagnosis of hip fracture, follow-up time, or calendar period. Our results are consistent with the a priori hypothesis that long-term estrogen deficiency is associated with a reduced risk of developing breast cancer as well as endometrial cancer.

Aged↗
PubMed1994

17 beta-oestradiol counteracts the formation of the more acidic isoforms of follicle-stimulating hormone and luteinizing hormone after menopause.

OBJECTIVE: When the gonadotrophin levels increase at midcycle, more basic isoforms of FSH and LH appear in the circulation. However, when these gonadotrophins increase at menopause more acidic forms appear. The present study was done to see whether chronic 17 beta-oestradiol (E2) administration to post-menopausal women could counteract the formation of the more acidic isoforms after the menopause. DESIGN: Serum samples were obtained from 16 post-menopausal women, mean age 70 years (range 63-84 years), 46-169 days after the subcutaneous insertion of a 20-mg E2-implant. FSH, LH and E2 in the sera were measured with fluoroimmunoassays. The median charge and the degree of charge heterogeneity of the FSH and LH isoforms were determined for each serum by electrophoresis in 0.1% agarose suspension. Sera from an age-matched control group were analysed in parallel. RESULTS: The E2 levels in the E2-treated women were 230-570 pmol/l, within the range expected during the mid-luteal phase of the normal menstrual cycle. The mean serum FSH and LH levels were similar to normal follicular phase FSH and LH levels (8.6 and 20.8% respectively of the control group). It was estimated that individual serum specimens from both groups contained 20-30 different isoforms for both FSH and LH. The median charges of the isoforms of FSH and LH were more basic in all the E2-treated subjects than in their corresponding untreated controls. The mean median charge for FSH was close to the values for the follicular and luteal phases and that for LH close to that for the luteal phase. In some E2-treated women the isoforms were even more basic with a charge similar to that at the midcycle peak. The degree of charge heterogeneity for the E2-treated group was significantly (P < 0.001) larger than for the controls and similar to that during the normal menstrual cycle. CONCLUSION: Chronic E2 administration to post-menopausal women counteracted the formation of more acidic isoforms of both FSH and LH after the menopause.

Aged↗
PubMed1993

Fracture of the distal forearm as a forecaster of subsequent hip fracture: a population-based cohort study with 24 years of follow-up.

OBJECTIVE: To determine the long-term risk of hip fracture following fracture of the distal forearm. DESIGN: Registry-based cohort study comparing patients with a fracture of the distal forearm with a population-based cohort. FRACTURE COHORT: All women and men above 40 years of age with a radiologically verified fracture of the distal forearm during a 5-year period, 1968-1972, in all 1,126 women and 212 men. CONTROL COHORT: An equal number of population-based, age- and sex-matched control persons selected from a population register. MEASUREMENTS: All cohort members were followed up individually through record linkage until the first hip fracture, emigration, death, or the end of 1991. The cohort members contributed a total of 40,832 person-years of observation, and altogether 365 cases of hip fractures were observed. RESULTS: Both women and men with a fracture of the distal forearm ran an increased risk of sustaining a subsequent hip fracture. The overall relative hazard for the women was 1.54 and for men 2.27. The increased risk in the women was independent of age at inclusion, but that in the men was more pronounced in the younger age groups. CONCLUSIONS: Patients with a fracture of the distal forearm run an increased risk of sustaining a subsequent hip fracture. They therefore appear to constitute a group in which appropriate prophylactic measures against osteoporosis and fractures should be considered.

Adult↗
PubMed1993

The risk of hip fractures in patients with primary hyperparathyroidism: a population-based cohort study with a follow-up of 19 years.

OBJECTIVE: To evaluate primary hyperparathyroidism (HPT) as a risk factor for hip fractures. DESIGN: A population-based, record-linked, prospective study with a mean observation time of 17 years (women) and 16.5 years (men). SETTING: A cohort obtained from a register of hospital admissions in the Uppsala Health Care Region, Sweden, 1965-1983. PARTICIPANTS: All patients (1373 women and 551 men) who were admitted to hospital with the diagnosis of HPT during the period. Comparisons were made with the entire background population. MEASUREMENTS: Cohort subjects were followed with regard to a first instance of hip fracture prior to or after the diagnosis of HPT. The observed number of cases was compared with that expected on the basis of person-years of observation and incidence rates in the background population. Analyses were made for cervical and trochanteric fractures, and for patients operated and not operated for HPT. MAIN RESULTS: (i) Women. During 23,341 person-years of observation, 67 cases of first hip fractures occurred, yielding a relative risk (RR) of 0.93 (95% confidence interval [CI] 0.72-1.19). The RR for cervical fractures was 0.77 (CI 0.54-1.06), and for trochanteric fractures 1.33 (CI 0.88-1.93). Operation for HPT did not influence the risk of hip fracture. (ii) Men. The total person-years was 9091. Eleven fractures were observed--compared with the expected 7.90 (RR 1.39; CI 0.69-2.50). Men operated for HPT had an increased risk for cervical hip fractures (RR 2.73; CI 1.18-5.39). Owing to the few fractures in this group (n = 8) the relevance of this is uncertain. CONCLUSIONS: This study indicates that HPT is not a risk factor for hip fractures in women.

Aged↗
PubMed1993

Maintained bone density at advanced ages after long term treatment with low dose oestradiol implants.

OBJECTIVE: To investigate whether the bone preserving effect of low dose oestrogen replacement therapy (20 mg oestradiol implanted subcutaneously every six months) persists during continuous long term treatment through advanced ages. DESIGN: Cross sectional clinical study of postmenopausal women treated with oestradiol implants as compared with nonusers matched for age. SETTING: Outpatient research unit at a university hospital. SUBJECTS: Thirty-five women with a mean age of 67 years (range 47-83 years) at the time of investigation who, after a prior hysterectomy, had been treated with oestradiol implants for climacteric symptoms for a mean period of 16 years (range 5.5-31 years). The results were compared with those in women matched for age and without any diseases or medications known to affect the bone metabolism. MAIN OUTCOME MEASURES: Bone mineral densities (BMD) in the distal forearm, vertebrae and hip analysed by study group, age and duration of treatment. RESULTS: Implant users had a median serum oestradiol concentration in the luteal range, 313 (range 126-1711) pmol/l, and premenopausal levels of follicle stimulating hormone (FSH). All women except one who were given the standard dose at the standard intervals had serum oestradiol levels below 650 pmol/l. Compared with nonusers, women treated with oestradiol implants had 20 to 25% higher BMD at all measurement sites: distal radius (P < 0.0001), lumbar vertebrae (P < 0.0002) and femoral neck (P < 0.0001). These differences also remained after adjustment for potential confounders (height, age at menarche, parity, smoking habits, physical exercise and education) (P < or = 0.01 at all sites). In a multiple regression analysis the negative effect of advancing age was more than compensated by the positive effect of increasing treatment duration with a higher BMD at all measurement sites in women with a longer as compared with shorter, duration of treatment; the regression coefficients were significant (P < 0.05) in the spine and hip measurements. CONCLUSIONS: Continuous long term treatment with low dose oestradiol implants yielding physiological levels of serum oestradiol preserves both compact and cancellous bone and the effect seems to persist into advanced ages without any inevitable age related bone loss.

Aged↗
PubMed1992

Women with climacteric symptoms: a target group for prevention of rapid bone loss and osteoporosis.

The relations of vasomotor symptoms to the rate of bone loss and to the response of forearm bone mineral density (BMD) to hormone replacement therapy (HRT) were analyzed in a 2-year non-randomized study. Forty peri/postmenopausal women who were given HRT for climacteric symptoms were compared with untreated control women, individually matched for age and length of time since the last menstrual period. The women who received HRT gained, on average, about 2% in BMD, while the control women lost about 6% (mean group difference 8%; 95% confidence interval (CI) 5.7-10.2). Adjustment for potential confounders did not change the results. Sweating frequency was inversely correlated with serum estradiol levels (p = 0.05). Among untreated women the rate of bone loss was higher in those who had frequent sweating initially than in those with less frequent sweating (9% vs. 4%, mean difference 4.3%; 95% CI 0.7-7.8, p = 0.023). Among women who received HRT, those who had the highest frequency of sweating initially, compared with those with a lower frequency, showed a greater gain in bone density (mean difference 4%; 95% CI 1.2-6.8, p = 0.007). In multivariate analysis adjusting for covariates, sweating frequency remained an independent determinant of change in bone density in women both with and without HRT. When sweating frequency and serum estradiol levels were compared in a multivariate analysis, only sweating frequency showed an independent association with rate of bone loss. The findings indicate that women with severe climacteric symptoms may have an excessive rate of bone loss and should therefore be considered as a special target group for prevention of osteoporosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Reduced risk of hip fracture in women with endometrial cancer.

The effect of excessive endogenous oestrogens on the risk of hip fracture was investigated in a population-based cohort of 2111 women with endometrial carcinoma who were followed up from age 50 years regarding the occurrence of a first hip fracture. Overall, 77 cases of hip fracture were observed, as against 120.8 expected, which meant a significantly reduced relative risk, standardized incidence ratio (SIR) = 0.6, 95% confidence interval (CI): 0.5-0.8. This possible protective effect was significant for cervical fractures, SIR = 0.6 (95% CI: 0.4-0.8), but not for trochanteric, SIR = 0.8 (95% CI: 0.5-1.1). Age at endometrial cancer diagnosis was not a determinant of the risk of hip fracture. A lowered relative risk was present regardless of age at diagnosis and persisted during the entire follow-up period and into advanced ages. A case-control analysis within the cohort, and based on medical record data, indicated that a higher weight might be associated with a greater protective effect, as compared with a lower weight. Exposure to exogenous oestrogens was infrequent and could not have explained the present results. We conclude that persistent influence of oestrogens, notably of endogenous origin, can reduce the risk of hip fractures, and that this protective effect may be long-lasting and extend to advanced ages.

Adult↗