| Effect of gonadotropin-releasing hormone agonist and medroxyprogesterone acetate on calcium metabolism: a prospective, randomized, double-blind, placebo-controlled, crossover trial. | |
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MedLine Citation:
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PMID: 14607578 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to prospectively compare the effectiveness of administering medroxyprogesterone acetate (MPA; 20 mg/d) in either the first (protocol A) or last (protocol B) 12-week period as well as a 6-month course of the GnRH agonist (GnRH-a; leuprolide acetate; 1 mg/d, SC) on calcium (Ca) metabolism. DESIGN: Prospective, randomized, double-blind, placebo-controlled, crossover trial. SETTING: Clinical research center, university hospital. PATIENT(S): Twenty women were randomized into protocol A or B, received either MPA or placebo along with GnRH-a, and were then crossed over at 12 weeks to placebo or MPA, for the final 12-week interval of GnRH-a therapy. INTERVENTION(S): Collection of serum and urine samples and measurement of bone density. Sex hormone, calcitropic hormone, and bone density studies were performed at baseline and at 12 and 24 weeks. RESULT(S): In both protocol A and B, LH and E(2) levels declined by 79%-81% and 83%-90% of the baseline, respectively, at 12 and 24 weeks. Serum Ca, phosphorus, alkaline phosphatase, and osteocalcin; 2-h fasting and 24-h urinary Ca excretion; and urinary hydroxyproline levels all increased significantly during GnRH-a treatment alone. Estimated Ca balance decreased significantly during GnRH-a treatment alone. The addition of MPA attenuated the increases in phosphorus, alkaline phosphatase, osteocalcin, and 2-h fasting and 24-h urinary Ca excretion, and the decrease in estimated Ca balance. Comparison of phase order demonstrated that MPA prevented 24-h urinary Ca excretion and urinary hydroxyproline loss and decline in estimated Ca balance when it was added back during the second 12 weeks (protocol B) but not during the first 12 weeks (protocol A). CONCLUSION (S): We conclude that sequential MPA appears to reverse in part the negative effects of GnRH-a on calcitropic hormones and estimated Ca balance. |
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Authors:
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Bruce R Carr; Neil A Breslau; Noel Peng; Beverley Adams-Huet; Karen D Bradshaw; Michael P Steinkampf |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Fertility and sterility Volume: 80 ISSN: 0015-0282 ISO Abbreviation: Fertil. Steril. Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-11-10 Completed Date: 2003-12-19 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 1216-23 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032, USA. bruce.carr@utsouthwestern.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bone Density Calcium / blood, metabolism*, urine Cross-Over Studies Double-Blind Method Endometriosis / drug therapy, metabolism* Female Gonadotropin-Releasing Hormone / agonists* Homeostasis Humans Leiomyomatosis / drug therapy, metabolism* Leuprolide / therapeutic use* Medroxyprogesterone Acetate / therapeutic use* Placebos Uterine Neoplasms / drug therapy, metabolism* |
| Grant Support | |
ID/Acronym/Agency:
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M01-RR-00633/RR/NCRR NIH HHS; R01 HD-25860/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Placebos; 33515-09-2/Gonadotropin-Releasing Hormone; 53714-56-0/Leuprolide; 71-58-9/Medroxyprogesterone Acetate; 7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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