The changes of bone mineral density and biochemical bone markers after GnRH agonist treatment in patients with endometriosis / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To investigate the basal bone mineral density(BMD)s of the lumbar spine and femur of patients with endometriosis, and the changes of BMDs and biochemical bone markers after 6 months of gonadotropin releasing hormone(GnRH) agonist treatment. METHODS: The initial BMDs of 35 women with endometriosis were measured by dual energy x-ray absorptiometry at department of obstetrics & gynecology Yongsan Hospital, College of Medicine, Chung Ang University from April 1996 to May 1999. 19 patients of these group was repeatedly measured after 3.6mg subcutaneous depot injection of goserelin(Zoladex) every 4 weeks for 24 weeks. Osteocalcin and Deoxypyridinoline were measured before goserelin treatment, at 3 months, and at 6 months completion of goserelin treatment. RESULTS: Patients with endometriosis did not show the significant difference in mean BMD of lumbar spine and femur in comparison with age matched normal women. Patients treated with goserelin for 6 months showed 0.064+/-0.030g/cm2(5.56%) decrease of BMD in lumbar spine, 0.038+/-0.040g/cm2(3.85%) decrease in femur neck, 0.055+/-0.047g/cm2(6.10%) decrease in Ward triangle, 0.041+/-0.031g/cm2(5.19%) decrease in femoral trochanter. These data had statistical significance(p<0.001). At first 3 months and on completion of 6 months goserelin treatment, there were increase of 66.1%, 122.3% in serum osteocalcin respectively, and increase of 35.2%, 39.6% in urine deoxypyridinoline respectively, compared with pretreatment value. CONCLUSION: From these results, it is concluded that the BMDs of patients with endometriosis were normal, and after 6 months GnRH agonist treatment, bone loss was 3.85%-6.10%, and the values of biochemical bone markers were increased.