Metabolism: clinical and experimental
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Randomized Controlled Trial Comparative Study
Influence of modified transdermal hormone replacement therapy on the concentrations of hormones, growth factors, and bone mineral density in women with osteopenia.
The metabolic and therapeutic action of estrogens depends on their type, dosage, form, route of administration, and treatment-free interval during the therapeutic cycle. Hormone therapy is generally subclassified into 2 forms that differ in the type of hormones. In hormonal replacement therapy (HRT), estrogens and progesterone components do not differ in chemical structure and molecular mass from those naturally produced by the female organism. ⋯ No significant changes were shown in osteocalcin and in carboxyterminal propeptide of type I procollagen in all groups. Increase in bone mineral density L(2)-L(4) was statistically significant in the group receiving modified transdermal HRT (P < .01) and was insignificant in women receiving orally given HST after 12 months of therapy as compared with baseline values. Following are the conclusions: (1) Low-dose modified transdermal HRT modulates concentration of hormones, growth factor, IGF-I, osteocalcin, procollagen, and bone metabolism. (2) The curve concentrations of estrogens and progesterone in serum are similar to the type observed in the physiologic menstrual cycle. (3) The lack of significant increase in bone mineral density of lumbar spine in women after HST may be a result of significantly lower concentration of IGF-I in serum and occurring hyperprolactinemia.