Steroidal contraceptive use is associated with lower bone mineral density in polycystic ovary syndrome

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• 作者：Lisa J. Moran ; R. L. Thomson ; J. D. Buckley ; M. Noakes ; P. M. Clifton…
• 关键词：Polycystic ovary syndrome ; Overweight ; Bone mineral density ; Contraceptive
• 刊名：Endocrine
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：50
• 期：3
• 页码：811-815
• 全文大小：341 KB
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• 作者单位：Lisa J. Moran (1)
  R. L. Thomson (2)
  J. D. Buckley (2)
  M. Noakes (3)
  P. M. Clifton (2)
  R. J. Norman (1) (3)
  G. D. Brinkworth (4)
  
  1. The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, 55 King William Road, North Adelaide, SA, 5006, Australia
  2. Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
  3. Fertility SA, Adelaide, SA, Australia
  4. CSIRO Food and Nutrition, Adelaide, SA, Australia
  
• 刊物主题：Endocrinology; Diabetes; Internal Medicine; Science, general;
• 出版者：Springer US
• ISSN：1559-0100

文摘

Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with features including hyperandrogenism and menstrual irregularity frequently treated with hormonal steroidal contraceptives. Women with PCOS appear to have lower bone mineral density (BMD). While steroidal contraceptives may positively affect bone health, their effect on BMD in PCOS is not known. The aim of this study was to assess BMD in women with PCOS according to recent contraceptive use. A cross-sectional analysis of 95 pre-menopausal overweight or obese sedentary women with PCOS [age 29.4 ± 6.4 years, body mass index (BMI) 36.1 ± 5.3 kg/m2] who either recently took steroidal contraceptives (ceased 3 months prior) or were not taking steroidal contraceptives was conducted. Clinical outcomes included BMD, anthropometry, insulin, glucose, reproductive hormones, dietary intake and vitamin use. BMD was significantly lower for women who used contraceptives compared to those who did not (mean difference 0.06 g/cm2 95 % confidence interval ?.11, ?.02, p = 0.005). In regression models, lower BMD was independently associated with contraceptive use (β = ?.05, 95 % CI ?.094, ?.002, p = 0.042), higher testosterone (β = ?.03, 95 % CI ?.05, ?.0008, p = 0.043) and lower BMI (β = 0.006, 95 % CI 0.002, 0.01, p = 0.007) (r 2 = 0.22, p = 0.001 for entire model). We report for the first time that overweight and obese women with PCOS with recent steroidal contraceptive use had lower BMD in comparison to non-users independent of factors known to contribute to BMD. Whether this observation is directly related to steroidal contraceptive use or other factors requires further investigation. Keywords Polycystic ovary syndrome Overweight Bone mineral density Contraceptive