Jarmo Saarelainen1, Saara Hassi2, Risto Honkanen3, Heli Koivumaa-Honkanen4, Joonas Sirola5, Heikki Kröger5, Marja H Komulainen6, Marjo Tuppurainen7. 1. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland. Electronic address: jtsaarel@student.uef.fi. 2. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland. 3. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland; Department of Psychiatry, Lapland Hospital District, 96101 Rovaniemi, Finland. 4. Department of Psychiatry, Lapland Hospital District, 96101 Rovaniemi, Finland; Institute of Clinical Medicine, Psychiatry, UEF, 70210 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, 70029 Kuopio, Finland. 5. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland; Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, 70029 Kuopio, Finland. 6. Department of Obstetrics and Gynaecology, Kuopio University Hospital, 70029 Kuopio, Finland. 7. Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland; Department of Obstetrics and Gynaecology, Kuopio University Hospital, 70029 Kuopio, Finland.
Abstract
CONTEXT: Long-term bone mineral density (BMD) or fracture incidence changes after withdrawal of postmenopausal hormone therapy (HT) are not well known. OBJECTIVE: To study long-term postmenopausal bone loss and incidence of wrist fracture in respect to duration and withdrawal of self-reported HT. DESIGN/ SETTING: A 15-year follow-up of the population-based prospective OSTPRE cohort in Kuopio, Finland. PARTICIPANTS: Women (mean baseline age 53.4 years, range 48.1-59.6) were divided into four groups based on duration of HT: (1) never users (non-HT); (2) those who had used HT only throughout the 1st 5-year period (HT5); (3) throughout the first 10-years (HT10); (4) those who used HT throughout the entire 15-year follow-up (HT15). OUTCOME MEASURES: Femoral (n=857) and spinal (n=599) BMD measurements with dual X-ray absorptiometry (DXA) were carried out at 5-year intervals in 1989-2004. Wrist fracture incidence in 1989-2004 was studied in a population of 5119 women. RESULTS: The adjusted spinal BMD (L2-L4) changes by HT use during the entire 15-year follow-up were -4.8% for non-HT (p<0.0001), -4.2% for HT5 (p=0.003), +0.02% for HT10 (p>0.05) and +3.2% for HT15 (p<0.0001) groups. The respective femoral bone losses were -8.6% for non-HT (p<0.0001), -7.9% for HT5 (p<0.0001), -2.5% for HT10 (p=0.010) and -0.2% for HT15 (p>0.05) groups. Comparing to non-HT group the risk of wrist fracture was reduced by 33% (p=0.045) in HT10 group and by 63% (p<0.0001) in HT15 group during the 15-year follow-up. CONCLUSION: Long-term HT-use protects from bone loss. Thus, it reduces the incidence of osteopenia, osteoporosis and wrist fractures. Still, HT-use of less than 5 years did not have long-term bone protective effects, but a larger sample size is needed to confirm this result.
CONTEXT: Long-term bone mineral density (BMD) or fracture incidence changes after withdrawal of postmenopausal hormone therapy (HT) are not well known. OBJECTIVE: To study long-term postmenopausal bone loss and incidence of wrist fracture in respect to duration and withdrawal of self-reported HT. DESIGN/ SETTING: A 15-year follow-up of the population-based prospective OSTPRE cohort in Kuopio, Finland. PARTICIPANTS: Women (mean baseline age 53.4 years, range 48.1-59.6) were divided into four groups based on duration of HT: (1) never users (non-HT); (2) those who had used HT only throughout the 1st 5-year period (HT5); (3) throughout the first 10-years (HT10); (4) those who used HT throughout the entire 15-year follow-up (HT15). OUTCOME MEASURES: Femoral (n=857) and spinal (n=599) BMD measurements with dual X-ray absorptiometry (DXA) were carried out at 5-year intervals in 1989-2004. Wrist fracture incidence in 1989-2004 was studied in a population of 5119 women. RESULTS: The adjusted spinal BMD (L2-L4) changes by HT use during the entire 15-year follow-up were -4.8% for non-HT (p<0.0001), -4.2% for HT5 (p=0.003), +0.02% for HT10 (p>0.05) and +3.2% for HT15 (p<0.0001) groups. The respective femoral bone losses were -8.6% for non-HT (p<0.0001), -7.9% for HT5 (p<0.0001), -2.5% for HT10 (p=0.010) and -0.2% for HT15 (p>0.05) groups. Comparing to non-HT group the risk of wrist fracture was reduced by 33% (p=0.045) in HT10 group and by 63% (p<0.0001) in HT15 group during the 15-year follow-up. CONCLUSION: Long-term HT-use protects from bone loss. Thus, it reduces the incidence of osteopenia, osteoporosis and wrist fractures. Still, HT-use of less than 5 years did not have long-term bone protective effects, but a larger sample size is needed to confirm this result.