Impact of premature ovarian failure and hormone replacement therapy on androgens and bone mineral density in karyotypically normal (46,XX) patients

Abstract

Aim. In this study, our aim was to evaluate the impact of premature ovarian failure and hormone replacement therapy on androgens and bone mineral density in karyotypically normal (46,XX) patients. Methods. Forty-six patients with a diagnosis of POF were selected for this cross-sectional study. All patients were karyotyped as 46,XX. Fifteen young women in reproductive age served as the first control group and were matched by age. Fifteen healthy women in natural menopause served as the second control group. Both lumbar spine (L2-L4) and the total femur were chosen as measurement sites for BMD. Cross-linked N-telopeptides of type I collagen (NTX) was measured as a marker of bone resorption. Results. There was a significant difference in E2 and FSH levels between groups. There was also a significant difference in lumbar spine and total femur scores. Patients with POF were stratified by age and HRT. DHEA-S level was significantly higher in patients who were younger than 30 years old and using HRT (0.576±0.86 versus 1.78±1.22; P=0.04). When patients were compared according to age, there were significant differences in E2 level, FSH level, lumbar spine and total femur scores. Total testosterone correlated negatively with NTX and Beck score. BMI correlated positively with lumbar spine and total femur scores. Conclusion. The early detection of POF can provide an opportunity for timely therapeutic intervention. HRT is strongly advised, since early loss of sufficient estrogen production is associated with skeletal, cardiovascular and neuropsychological complications.