A comparison of bone mineral density in oligomenorrhoeic adolescents with polycystic ovaries and normal ovaries.

We evaluated whether the presence of polycystic ovaries in adolescent girls as a cause of oligomenorrhoea and amenorrhoea would pose any protective effect against osteoporosis or low bone mineral density (BMD) compared with girls having similar menstrual dysfunction but normal ovaries. A cross-sectional observational study was done in consecutive girls, aged between 16 and 19 years, presenting to the adolescent gynaecology clinic with oligomenorrhoea or amenorrhoea. All patients underwent full hormonal profile assessment, pelvic ultrasound for ovarian morphology, bio-impedance estimation of body fat, and dual-energy X-ray absorptiometry and quantitative peripheral computed tomography scans to determine BMD in axial and appendicular skeletal sites. Polycystic ovaries were diagnosed according to ultrasound morphology. These were then compared with an age-matched eumenorrhoeic control group that had undergone the same evaluation. Of 45 patients with oligomenorrhoea or amenorrhoea, 14 (31%) were diagnosed to have polycystic ovaries, while the other 31 had normal ovaries. The control group consisted of 45 age-matched eumenorrhoeic girls. The group with normal ovaries had lower BMD at the lumbar spine and hip, as well as lower total tibial volumetric BMD, than the eumenorrhoeic controls, but there were no significant differences between the group with polycystic ovaries and eumenorrhoeic controls. We conclude that adolescents with oligomenorrhoea and amenorrhoea with normal ovaries had lower BMD than eumenorrhoeic ones, but those with polycystic ovaries had BMD values comparable to those of eumenorrhoeic controls despite their menstrual dysfunction.     

A comparison of bone mineral density in normal weight and obese adolescents with polycystic ovary syndrome

Study ObjectiveTo evaluate whether there are any differences in bone mineral density (BMD) between normal weight and obese adolescents suffering from polycystic ovary syndrome (PCOS) with oligo/amenorrhea.DesignProspective cohort study.SettingAdolescent gynecology clinic in a general service hospital.ParticipantsSubjects consisted of adolescents between 16 to 18 years of age presenting with oligo/ amenorrhea with ultrasound morphology of polycystic ovaries ± evidence of hyperandrogenism over 24 months. Controls consisted of consecutive eumenorrheic patients within the same age group.InterventionsAll underwent full hormonal profile assessment, and dual energy X-ray absorptiometry and peripheral quantitative computed tomography scans.Main Outcome MeasuresAreal and volumetric BMD parameters.ResultsOf 37 adolescents with PCOS, 12 (32%) were obese with BMI ≥25, of which 9/12 (75%) were hyperandrogenic. The control group consisted of 40 normal weight eumenorrheic girls. The PCOS group overall had lower lumbar spine BMD values as compared to the controls (0.91 vs 0.97 g/ cm², P = 0.033). The normal weight PCOS group had lower BMD at the spine (0.90 vs 0.97 g/ cm², P = 0.027), trochanter (0.66 vs 0.71 g/ cm², P = 0.039) as well as volumetric distal tibial core sites (268 vs 296 mg/ cm³) as compared to eumenorrheic controls, but there were no significant BMD differences between the obese PCOS group and the eumenorrheic controls.ConclusionsNormal weight PCOS adolescents with oligo/amenorrhea have marginally lower BMD values than controls, but obese PCOS adolescents have BMD values compatible with eumenorrheic adolescents.     

Comparison of oocyte quality and intracytoplasmic sperm injection outcome in women with isolated polycystic ovaries or polycystic ovarian syndrome

Objective To compare the oocyte quality and intracytoplasmic sperm injection performance in women with isolated polycystic ovaries or polycystic ovarian syndrome. Design Retrospective study. Setting Fertility unit. Population Three study groups were identified: women with PCO-only morphology (50 cycles), PCOS (51 cycles) and age matched control group (104 cycles) with isolated male factor infertility necessitating ICSI. Method Controlled ovarian hyperstimulation and ICSI. Main outcome measures Response to gonadotropin stimulation, oocyte and embryo quality, clinical pregnancy rate and pregnancy outcome. Results Despite a significantly lower total gonadotropin dose, a significantly higher serum E2 level was attained in both the PCOS and the PCO-only groups compared to the control group. Although significantly more oocytes were retrieved in the PCOS and PCO-only groups, the number of 2-pronuclear embryos was similar to controls. No significant differences were noted in the maturity of the oocytes, oocyte dysmorphism, embryo quality, implantation and pregnancy rates among the three groups. However the clinical miscarriage rate was significantly lower in women with PCO-only morphology group (15.4 versus 31%, P < 0.05) than in the PCOS group. Conclusion Women with PCO-only appearance have shown to have similar characteristics to women with PCOS in terms of ovarian response to hMG stimulation, oocyte and embryo quality and pregnancy rates. However miscarriage rates were significantly lower in the PCO-only group than the PCOS group. Our findings suggest that factors unrelated to oocyte and embryo morphology present in PCOS patients may be instrumental in adverse reproductive outcomes in these women.     

Increase in nerve fibers and loss of mast cells in polycystic and postmenopausal ovaries

Objective: To quantify nerve fibers and mast cells in human ovaries at different functional stages.

Design: Retrospective study.

Setting: Research laboratory of the university.

Specimen(s): 8 human ovaries in the follicular (cyclic) phase, 7 polycystic ovaries, and postmenopausal ovaries with (n=5) or without (n=7) hyperthecosis.

Main Outcome Measure(s): Single- and double immunohistology for the S100 antigen in glial cells of autonomic nerve fibers, for chymase and tryptase in mast cells, and for the common leukocyte antigen on leukocytes. Histometric evaluation was also performed.

Intervention(s): None.

Result(s): Polycystic ovaries contained significantly more S100-positive nerve fibers in the corticomedullary region than did cyclic ovaries (mean ± SD per 2-mm² area, 476 ± 136 and 224 ± 133; P<.01). Postmenopausal ovaries with or without hyperthecosis had the highest density of nerve fibers. In cyclic and polycystic ovaries, more tryptase-positive mast cells than chymase-positive mast cells were found in the interstitial cortex and the medulla. In cyclic ovaries, areas with a moderate density of nerve fibers contained many mast cells. Hence, with increasing nerve fiber density in polycystic ovaries, the number of mast cells decreased strikingly compared with cyclic ovaries (p<.001). Almost no mast cells were seen in postmenopausal ovaries with and without hyperthecosis. The number of leukocyte antigen–positive leukocytes was similar in all groups.

Conclusion(s): The high density of nerve fibers in polycystic and postmenopausal ovaries, together with a conspicuous decrease in mast cells, indicates altered neuroimmune communication.     

Determinants of low bone mineral density in premenopausal polycystic ovary syndrome patients

Objective: The aim of this study was to evaluate the bone mineral density (BMD) values and to determine the associations between BMD and insulin sensitivity, hyperandrogenemia, body mass index (BMI), and sex hormones in premenopausal polycystic ovary syndrome (PCOS) patients.

Methods: A hundred and three women with PCOS and sixty age- and BMI-matched healthy control women were enrolled to this cross-sectional study. Serum androgen and estradiol (E2) levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) and MATSUDA insulin sensitivity index (ISI) were calculated. BMD was measured with a dual X-ray absorptiometer.

Results: Lumbar BMD (LBMD) and femoral neck BMD (FnBMD) values were significantly lower in PCOS group than controls [(p?p?p?p?r?=?0.617; p?r?=??0.665; p?r?=?0.488; p?r?=?0.436; p?r?=?0.337; p?Conclusions: Despite the positive effects of hyperandrogenemia and hyperinsulinemia, PCOS patients have lower bone mineral density due to hypoestrogenism. Insulin resistance, BMI, estrogen, and androgen levels are the determinants of BMD in PCOS.     

Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment

Purpose

This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment.

Methods

We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle.

Results

Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2 %) compared to controls (4.9 %). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3 %), but not the PCOS group (50.0 %), compared to controls (47.5 %).

Conclusions

Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.     

肥胖儿童骨密度变化及其影响因素分析

分析肥胖儿童骨密度（BMD）及其影响因素,为早期预防骨质疏松提供科学依据。方法　2007年1—12月从长沙市开福区5所小学7～12岁学龄儿童中 ,按照体质指数（BMI）法诊断单纯性肥胖,随机抽取119例单纯性肥胖儿童及103名正常儿童。采用双能X线骨密度仪（DEXA）全身扫描,测量BMD和身体成分。结 果　单纯性肥胖儿童的身高、体重、BMI、腰围和腰臀比均显著高于正常儿童。单纯性肥胖儿童的各部位瘦组织含量（LM）、脂肪组织含量（FM）、体脂百分比（ PBF）及躯干脂肪组织百分比均显著高于正常儿童,但四肢FM百分比却显著低于正常儿童。肥胖儿童各部位BMD和骨矿物质含量（BMC）均大于正常儿童。控制FM后 ,BMD（或BMC）与LM呈显著正相关：控制LM后,BMC与FM亦呈正相关。多元逐步回归分析显示,影响儿童BMD的主要因素是LM。 结论　肥胖儿童BMD高于正常儿童 ,LM对儿童成长中骨的BMD起重要作用。     

The influence of other than prolactin hormones on bone mineral density in women with hyperprolactinaemia of various origins

Objective.?Hyperprolactinaemia may lead to bone loss, both due to hypogonadism and other hormonal disturbances. Aim of the case–control study was the analysis of influences of hormonal profiles associated with hyperprolactinaemia on the bone mineral density (BMD) in women with hyperprolactinaemia of various origin.

Material and methods.?The subjects were 32 patients with prolactinoma, 43 ones with functional hyperprolactinaemia and 29 healthy controls. All of them were studied for BMD (lumbar spine, proximal femur, forearm, total body) by dual-energy X-ray absorptiometry and their correlations with hormones levels (prolactin, oestradiol, luteinising hormone, follicle stimulating hormone, sex hormone binding globulin (SHBG), testosterone, dehydroepiandrosterone sulphate (DHEA-S), insulin-like growth factor-1 and intact parathyroid hormone) using Spearman correlation analysis and multiple regression analysis model.

Results.?Correlation analysis revealed the anabolic influence of PTH on lumbar spine in women with prolactinoma, and on ultradistal radius in functional hyperprolactinaemia. In multiple regression analysis, oestradiol had greatest influence on lumbar spine and total body BMD. Moreover, positive influence of testosterone, SHBG on spine BMD, and of oestradiol, testosterone, SHBG and DHEA-S on total body BMD were observed in patients with prolactinoma.

Conclusion.?Hormonal disturbances associated with hyperprolactinaemia influence BMD more in patients with prolactinoma than in ones with functional hyperprolactinaemia.     

北京地区女性峰值骨密度与雌激素受体基因多态性的相关因素分析

目的 探讨影响北京女性峰值骨密度(peak hone mineral density，PBMD)和雌激素受体(estrogen receptor，ER)基因多态性的关系。方法 于2000年3月～2001年7月，选择健康志愿者159人，①使用DEXA(Holooc QDR4500)测量志愿者腰椎和髋部BMD；②从志愿者静脉全血(5～10ml)中提取DNA，应用PCR-限制性片段长度多态性法(restriction fragment length polymorphisms，PCR-RFLP)对ER进行多态性分析；③分析PBMD与身高、体重、体重指数(BMI)及ER基因多态性的相关关系。结果 ①腰椎BMD和身高、体重及BMI呈正相关，髋部股骨颈(Neck)位点BMD值和体重呈正相关，而髋部其余位点BMD值和BMI呈正相关．且Ward三角与ER PvuⅡ酶切位点有相关性；②ER基因PvuⅡ酶切结果显示在髋部Ward三角，PP基因型组的BMD明显低于Pp及pp基因型组，差异有显著性；③ER PvuⅡ和XbaI酶切位点的联合分析，PPxx基因型组BMD值在各位点均较高，PPXx基因型组BMD值在各位点均最低，在髋部股骨颈、粗隆间差异有显著性。在Ward三角位点，Ppxx基因型BMD值最高，与PPXx及PPXX基因型组有显著性差异，PPxx基因型组BMD值也较高。结论 ①体重及或BMI是女性PBMD重要保护因素之一；②ER基因多态性影响中国汉族女性峰值BMD结果。     

Relationship between serum leptin concentrations and bone mineral density as well as biochemical markers of bone turnover in women with postmenopausal osteoporosis

OBJECTIVE: To determine whether leptin is involved in bone remodeling in patients with postmenopausal osteoporosis. DESIGN: Cross-sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University. PATIENT(S): Ninety postmenopausal osteoporotic women (37 obese and 53 nonobese) and 30 healthy premenopausal women from the same clinic served as controls. Lumbar spine bone mineral density (LS-BMD) of osteoporotic patients was more than 2.5 SD below the normal mean of healthy premenopausal women. MAIN OUTCOME MEASURE(S): Serum levels of leptin, osteocalcin (OC), bone alkaline phosphatase (B-ALP), urinary deoxypyridinoline (DPyr), and N-telopeptide of type 1 collagen (NTX) as well as LS-BMD using dual energy X-ray absorptiometry (DEXA). RESULT(S): The serum leptin level in obese postmenopausal osteoporotic patients was significantly increased compared with nonobese osteoporotic patients. There were no significant differences of bone formation markers (B-ALP, OC), bone resorption markers (DPyr, NTX), or LS-BMD between the obese and nonobese groups. There were no significant correlations between serum leptin and any biomarkers of bone turnover and BMD. CONCLUSION(S): In postmenopausal osteoporotic patients with increased bone turnover, serum leptin concentration is not correlated with BMD or with the biomarkers of bone formation or bone resorption.     

Effect of daily hormone therapy and alendronate use on bone mineral density in postmenopausal women

OBJECTIVE: To evaluate the effect of daily oral and transdermal hormone therapy alone or in combination with alendronate on bone mineral density in postmenopausal women. DESIGN: Comparative prospective clinical study. SETTING: Outpatient clinic of a training and research hospital. PATIENT(S): One hundred seventy-three consecutive postmenopausal women with no previous hormone therapy and a bone mineral density T score <-1 SD were randomly enrolled. INTERVENTION(S): Oral conjugated estrogen, alone or with alendronate, or transdermal estrogen, alone or with alendronate, given for 1 year. All patients also received medroxyprogesterone acetate and calcium. MAIN OUTCOME MEASURE(S): Bone density measurement at L2 to 4 region by dual-energy X-ray absorptiometry. RESULTS: At the end of 1 year, significant increase in bone density measurements were seen in all groups. Oral conjugated estrogen and transdermal estrogen have the same effect on bone mineral density loss. Hormone therapy alone stabilized the bone mineral density loss. Hormone therapy together with alendronate resulted in better values in all groups. CONCLUSION: Hormone therapy is adequate in osteopenic women. However, hormone therapy plus alendronate is advantageous in women with considerable bone mineral density loss.     

A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults

Abstract

To find out if DHEA replacement improves bone mineral density (BMD) in healthy older adults. We systematically searched Medline via PubMed, Embase, and the Cochrane Library Center Register to identify randomized controlled trials up to October 2018. Effect estimates were performed in random effect models. Bone mineral density of hip and trochanter, total body, lumbar spine, and femoral neck were conducted. Hip BMD increased significantly above placebo group in women who took DHEA supplementation (SMD –0.5[–0.95, –0.04], p?=?.03). The SMD of trochanter BMD of women in placebo group than DHEA group was –0.55 [–1.10, 0.00], p?=?.05. Insulin-like growth factor 1 (IGF-1) did not change in men compared to placebo group also (–0.56 [–1.22, 0.10], p?=?.09). In women, IGF-1 significantly improved in DHEA supplementation group than placebo group (–2.61 [–4.85, –0.38], p?=?.02). In summary, the results of this meta-analysis suggest that DHEA replacement therapy can partially increase BMD of hip and trochanter in women. Similar results were not observed in men. More trials may be necessary to allow for a positive and clinically significant effect of DHEA on BMD.     

Difference in the relative contribution of lean and fat mass components to bone mineral density with generation

AIM: To investigate whether the relative contribution of body composition (lean and fat mass component) to bone mineral density (BMD) differs depending on generation or menopause. METHODS: Subjects were 302 premenopausal women aged 30-49 years old and 197 postmenopausal women aged 50-69 years old. They were classified into four subgroups with 10-year increments. Age, height, weight and years since menopause (YSM) were recorded. Lumbar spine (L2-4), total body BMD, body fat mass, lean body mass (LBM), and the percentage of body fat (%fat) were measured using dual-energy X-ray absorptiometry. The correlation of body composition with BMD was investigated. RESULTS: The mean age at menopause was 50.2 +/- 4.1 years old. On Pearson's correlation test, LBM was positively correlated with BMD of the two sites in all groups. In a group aged 60-69 years, both the %fat and body fat mass were correlated with BMD. On multiple regression analysis, LBM was the principal BMD determinant in women aged less than 60 years, while body fat mass and percentage fat were the principal BMD determinants in women aged 60-69 years. Mean %fat in the group aged 60-69 years was 35.5 +/- 7.3%, which was significantly higher than that in the group aged 50-59 years (33.0 +/- 6.7%, P < 0.05). CONCLUSION: Although LBM still influences BMD up to 10 years after menopause, the body fat mass initially influences BMD after 60 years of age. These difference may be attributable to certain aging-related factor(s).     

围绝经期和绝经后女性雌二醇和卵泡刺激素水平与骨密度的关系

目的研究围绝经期女性血清雌二醇(E2)及卵泡刺激素(FSH)变化规律及其与腰椎、髋部、股骨颈骨密度(bone mineral density,BMD)之间的关系。方法采用化学发光法测定402例就诊于北京友谊医院妇产科更年期门诊的40～65岁健康中国汉族女性早卵泡期或绝经后任意时期空腹血清E2和FSH水平,并采用双光能X线DXA测定其腰椎、总髋部、股骨近端BMD,分析血清E2和FSH与BMD的关系。结果低骨量组血清FSH水平显著高于正常组(P<0.05),E2水平显著低于正常组(P<0.05)。E2与BMD变化呈正相关(r=0.017～0.42,P<0.05);FSH与BMD变化呈负相关(r=-0.012～-0.94,P<0.05)。绝经后低骨量组FSH高于正常组,而E2无明显变化。结论血清E2和FSH水平与绝经前后妇女的BMD有关,绝经后FSH与BMD进一步丢失有关,而低水平雌激素可能不再是继续影响骨量的主要因素。     

Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin (Synarel)

OBJECTIVE: Our goal was to determine the effects of a repeated course of the gonadotropin-releasing hormone agonist nafarelin on symptoms and signs of endometriosis and lumbar and distal radius bone mineral density. STUDY DESIGN: Forty-five women previously treated for 6 months with nafarelin, who had recurrent symptoms and signs of endometriosis, received 400 mcg/day of nafarelin intranasally for 3 months. Efficacy was evaluated by changes in severity of symptoms and signs. Lumbar bone mineral density was measured by dual-energy x-ray absorptiometry and distal radius bone mineral density by single-photon absorptiometry. Bone mineral density was also measured in 10 control volunteers. RESULTS: Repeated 3-month treatment significantly alleviated recurrent symptoms and signs of endometriosis. Lumbar bone mineral density decreased significantly by a mean of 2% at the end of treatment; this loss was restored within 3 to 6 months after treatment completion. No bone mineral density decline occurred in the radius. Bone mineral density changes in the control group were statistically insignificant. CONCLUSIONS: A repeated 3-month course of nafarelin treatment significantly relieved recurrent endometriotic symptoms and signs without sustained loss of bone mineral density.(Am J Obstet Gynecol 1997;177:8)     

Concentration of vascular endothelial growth factor released by cultured human luteinized granulosa cells is higher in women with polycystic ovaries than in women with normal ovaries

To test the hypothesis that increased serum levels of vascular endothelial growth factor (VEGF) in women with polycystic ovaries or the polycystic ovary syndrome (PCOS) result from excess release by ovarian granulosa cells.Prospective study.Academic research setting.Twenty women undergoing IVF treatment, of whom 10 had normal ovaries and 10 had polycystic ovaries.Human granulosa lutein cells were isolated from follicular fluid obtained on the day of oocyte retrieval. Release of VEGF was assessed after co-incubation of granulosa lutein cells with gonadotropins and insulin. Serum and follicular fluid concentrations of VEGF were measured.Release of VEGF from granulosa lutein cells and serum levels of VEGF.Incubation with human hCG, and luteinizing hormone increased release of VEGF into the culture medium. Insulin alone did not increase release of VEGF, but addition of insulin increased hCG-stimulated release of VEGF. Serum and follicular fluid VEGF concentrations and the amount VEGF released from granulosa lutein cells obtained from women with polycystic ovaries or PCOS and those who developed the ovarian hyperstimulation syndrome were greater than those from granulosa lutein cells obtained from women with normal ovaries and those who did not develop the ovarian hyperstimulation syndrome.The amount of VEGF released by granulosa lutein cells is gonadotropin dependent and is augmented by insulin. The increased circulating concentrations of VEGF in women with PCOS may not only be due to an increased number of actively secreting granulosa lutein cells but also due to increased secretory capacity of each granulosa cell.     

Evaluation of body composition in POF and its association with bone mineral density and sex steroid levels

Abstract

The study aims to investigate the body composition and bone mineral density (BMD) characteristics and discuss the relationships among body composition, BMD and sex steroid level in POF. A total of 240 POF patients, 240 normal women, and peri/postmenopausal women (Peri-M/Post-M) (260 patients in each group) were included. Compared to the control group, POF patients? strength of left/right lower limb (SLL/SRL), muscle distributing coefficient of lower limbs (MD) decreased however, waist circumference (WC) and hip circumference (HC) increased. The weight, WC, HC, whole body fat percentage (BF%), average fat distribution (FD), MD of POF patients were lower than those among Peri-M and Post-M and BMD were lower than the Peri-M, yet still higher than Post-M. Moreover, BMD were significantly positively correlated with BF%, FD, SLL, MD and estradiol (E2). The factors associated with L2–L4 BMD were E2, SRL, FD and age. For the FN BMD, the factors were FD, E2 and SLL. Therefore, we conclude that maintenance of appropriate weight, physical exercise and hormone replacement treatment (HRT) may have positive effects on increasing BMD, improving muscle mass and muscle strength, preventing osteoporosis.     

Prediction of the change in bone mineral density induced by gonadotropin-releasing hormone agonist treatment for endometriosis

OBJECTIVE: To observe the long-term changes in bone metabolism induced by GnRH agonist (GnRHa) treatment and to determine the factor that affected the change in bone mineral density (BMD). DESIGN: Prospective observational study. SETTING: Department of obstetrics and gynecology in university and general hospitals. PATIENT(S): Fifty women with endometriosis treated with GnRHa between 1994 and 1996. INTERVENTION(S): Leuprolide acetate administered for 24 weeks. Bone mineral density measurement by dual energy x-ray absorptiometry and collection of blood and urine samples were conducted until 12 months of posttreatment. MAIN OUTCOME MEASURE(S): Spinal BMD and bone turnover markers. RESULT(S): Mean BMD percent changes from pretreatment were -4.9% and -3.4% at 6 months of treatment and at 12 months of posttreatment, respectively. When the patients were divided by the median pretreatment deoxypyridinoline (DP) level, recovery of BMD after GnRHa discontinuation was slower in the Low-DP group than in the High-DP group. A significant positive correlation was found between the pretreatment DP level and the percent change in BMD at 12 months of posttreatment. No significant relation between BMD and the other bone turnover markers was noted. CONCLUSION(S): Bone mineral density changes were diverse among patients who were administered GnRHa. The pretreatment DP level may be the predictive factor for GnRHa-induced BMD change.