Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study
Background: Estrogen therapy (ET) is associated with lower serum calcium and phosphorus concentrations and is known to increase bone mineral density (BMD). Other biomarkers of mineral metabolism may help understand the biological basis of these actions. Methods: We studied 2767 postmenopausal women...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2013-12, Vol.98 (12), p.4890-4898 |
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| creator | Bansal, Nisha Katz, Ronit de Boer, Ian H Kestenbaum, Bryan Siscovick, David S Hoofnagle, Andrew N Tracy, Russell Laughlin, Gail A Criqui, Michael H Budoff, Mathew J Li, Dong Ix, Joachim H |
| description | Background:
Estrogen therapy (ET) is associated with lower serum calcium and phosphorus concentrations and is known to increase bone mineral density (BMD). Other biomarkers of mineral metabolism may help understand the biological basis of these actions.
Methods:
We studied 2767 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis, 862 (31%) of whom were using ET. We measured serum concentrations of calcium, phosphorus, 25-hydroxyvitamin D, 24,25-dihydoxyvitamin D, and fibroblast growth factor-23 and urinary fractional excretion of calcium (FEca) and phosphorus (FEphos). We examined the associations of ET with each biomarker. In addition, we tested whether the adjustment for biomarkers attenuated the association of ET with lumbar BMD measured by abdominal computed tomography in a subset of 810 women.
Results:
In adjusted models, women who used ET were younger in age [62 (SD 8) vs 66 (9) y, P < .001], had lower mean serum calcium [−13 mg/dL (95% confidence interval [CI] −0.17, −0.10), P < .001] and lower FEca [−0.15% (95% CI −0.21, −0.09), P < .001]. Mean serum phosphorus was lower [−0.19 mg/dL (95% CI −0.23, −0.15), P < .001] and FEphos [0.56% (95% CI 0.16, 0.96), P = .007] was higher in women on ET. Mean 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D were higher [1.52 ng/dL (95% CI 0.57, 2.47), P = .002, and 0.26 ng/mL (95% CI 0.03, 0.48), P = .03, respectively] in women who used ET. Mean PTH and fibroblast growth factor-23 did not differ significantly by the use of ET. ET use was strongly associated with higher lumbar BMD [12.75 mg/cm3 (95% CI 7.77–17.73), P < .001]; however, mineral metabolism measures did not meaningfully alter this association.
Conclusions:
In a multiethnic cohort of postmenopausal women, ET use was associated with lower serum calcium, lower FEca, lower serum phosphorus, and higher FEphos, suggesting these associations are attributable to increased calcium intake into bone and increased urinary phosphorus excretion. ET use was also associated with greater concentrations of vitamin D metabolites. ET-associated differences in these mineral metabolism measures did not meaningfully attenuate the strong association between ET use and lumbar BMD. |
| doi_str_mv | 10.1210/jc.2013-2286 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3849680</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1611618582</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6023-ff49346158b14e1ef7c58024305f4ac623868eb078fbe8e53ff5f092065c4cd43</originalsourceid><addsrcrecordid>eNqFkd9rFDEQxxdR7Fl981nyIvhwW_Nrd7M-COW42kKlxVb0LeRyk9s9s8ma7LYc_vNmubMqCIaBMMlnvjPDN8teEnxCKMFvt_qEYsJySkX5KJuRmhd5RerqcTbDmJK8rujXo-xZjFuMCecFe5odUY5rKmgxy35cOGNHcBqQN2gZh-A34NBtA0H1O-QdWiir27Gbo-vGx77xYYxzpNwaXQ0JQp9gM1o1-LBD5z503kFErUPXPg4dON-rMSqLvviUvJtk0cflzSm6Gcb17nn2xCgb4cXhPs4-ny1vF-f55dWHi8XpZa5LTFluDK8ZL0khVoQDAVPpQmDKGS4MV7qkTJQCVrgSZgUCCmZMYdJ-uCw012vOjrP3e91-XHWw1uCGoKzsQ9upsJNetfLvH9c2cuPvJBO8LgVOAm8OAsF_HyEOsmujBmuVAz9GSUqSQhSC_h_lZSFSiDqh8z2qg48xgHmYiGA5WSu3Wk7WysnahL_6c4sH-JeXCXh9AFTUypqgnG7jby4tQktWJY7vuXtvBwjxmx3vIcgGlB0aidPhZSXyqTOhKcunF5bK2L4M3Nrr0DroA8Qot34MLtn376l_AqGnzUE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1465865889</pqid></control><display><type>article</type><title>Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Bansal, Nisha ; Katz, Ronit ; de Boer, Ian H ; Kestenbaum, Bryan ; Siscovick, David S ; Hoofnagle, Andrew N ; Tracy, Russell ; Laughlin, Gail A ; Criqui, Michael H ; Budoff, Mathew J ; Li, Dong ; Ix, Joachim H</creator><creatorcontrib>Bansal, Nisha ; Katz, Ronit ; de Boer, Ian H ; Kestenbaum, Bryan ; Siscovick, David S ; Hoofnagle, Andrew N ; Tracy, Russell ; Laughlin, Gail A ; Criqui, Michael H ; Budoff, Mathew J ; Li, Dong ; Ix, Joachim H</creatorcontrib><description>Background:
Estrogen therapy (ET) is associated with lower serum calcium and phosphorus concentrations and is known to increase bone mineral density (BMD). Other biomarkers of mineral metabolism may help understand the biological basis of these actions.
Methods:
We studied 2767 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis, 862 (31%) of whom were using ET. We measured serum concentrations of calcium, phosphorus, 25-hydroxyvitamin D, 24,25-dihydoxyvitamin D, and fibroblast growth factor-23 and urinary fractional excretion of calcium (FEca) and phosphorus (FEphos). We examined the associations of ET with each biomarker. In addition, we tested whether the adjustment for biomarkers attenuated the association of ET with lumbar BMD measured by abdominal computed tomography in a subset of 810 women.
Results:
In adjusted models, women who used ET were younger in age [62 (SD 8) vs 66 (9) y, P < .001], had lower mean serum calcium [−13 mg/dL (95% confidence interval [CI] −0.17, −0.10), P < .001] and lower FEca [−0.15% (95% CI −0.21, −0.09), P < .001]. Mean serum phosphorus was lower [−0.19 mg/dL (95% CI −0.23, −0.15), P < .001] and FEphos [0.56% (95% CI 0.16, 0.96), P = .007] was higher in women on ET. Mean 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D were higher [1.52 ng/dL (95% CI 0.57, 2.47), P = .002, and 0.26 ng/mL (95% CI 0.03, 0.48), P = .03, respectively] in women who used ET. Mean PTH and fibroblast growth factor-23 did not differ significantly by the use of ET. ET use was strongly associated with higher lumbar BMD [12.75 mg/cm3 (95% CI 7.77–17.73), P < .001]; however, mineral metabolism measures did not meaningfully alter this association.
Conclusions:
In a multiethnic cohort of postmenopausal women, ET use was associated with lower serum calcium, lower FEca, lower serum phosphorus, and higher FEphos, suggesting these associations are attributable to increased calcium intake into bone and increased urinary phosphorus excretion. ET use was also associated with greater concentrations of vitamin D metabolites. ET-associated differences in these mineral metabolism measures did not meaningfully attenuate the strong association between ET use and lumbar BMD.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2013-2286</identifier><identifier>PMID: 24092825</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>24,25-Dihydroxyvitamin D 3 - blood ; 24,25-Dihydroxyvitamin D 3 - metabolism ; 25-Hydroxyvitamin D 2 - blood ; 25-Hydroxyvitamin D 2 - metabolism ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biomarkers - blood ; Biomarkers - metabolism ; Biomarkers - urine ; Bone and Bones - diagnostic imaging ; Bone and Bones - drug effects ; Bone and Bones - metabolism ; Bone Density - drug effects ; Calcifediol - blood ; Calcifediol - metabolism ; Calcium - blood ; Calcium - urine ; Cohort Studies ; Cross-Sectional Studies ; Endocrine Research ; Endocrinopathies ; Ergocalciferols - blood ; Ergocalciferols - metabolism ; Estrogen Replacement Therapy ; Feeding. Feeding behavior ; Female ; Fibroblast Growth Factors - blood ; Fundamental and applied biological sciences. Psychology ; Humans ; Medical sciences ; Middle Aged ; Osteoporosis, Postmenopausal - blood ; Osteoporosis, Postmenopausal - diagnostic imaging ; Osteoporosis, Postmenopausal - metabolism ; Osteoporosis, Postmenopausal - prevention & control ; Phosphorus - blood ; Phosphorus - urine ; Radiography ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Vitamin D - analogs & derivatives ; Vitamin D - blood ; Vitamin D - metabolism</subject><ispartof>The journal of clinical endocrinology and metabolism, 2013-12, Vol.98 (12), p.4890-4898</ispartof><rights>Copyright © 2013 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2013 by The Endocrine Society 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6023-ff49346158b14e1ef7c58024305f4ac623868eb078fbe8e53ff5f092065c4cd43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28032637$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24092825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bansal, Nisha</creatorcontrib><creatorcontrib>Katz, Ronit</creatorcontrib><creatorcontrib>de Boer, Ian H</creatorcontrib><creatorcontrib>Kestenbaum, Bryan</creatorcontrib><creatorcontrib>Siscovick, David S</creatorcontrib><creatorcontrib>Hoofnagle, Andrew N</creatorcontrib><creatorcontrib>Tracy, Russell</creatorcontrib><creatorcontrib>Laughlin, Gail A</creatorcontrib><creatorcontrib>Criqui, Michael H</creatorcontrib><creatorcontrib>Budoff, Mathew J</creatorcontrib><creatorcontrib>Li, Dong</creatorcontrib><creatorcontrib>Ix, Joachim H</creatorcontrib><title>Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Background:
Estrogen therapy (ET) is associated with lower serum calcium and phosphorus concentrations and is known to increase bone mineral density (BMD). Other biomarkers of mineral metabolism may help understand the biological basis of these actions.
Methods:
We studied 2767 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis, 862 (31%) of whom were using ET. We measured serum concentrations of calcium, phosphorus, 25-hydroxyvitamin D, 24,25-dihydoxyvitamin D, and fibroblast growth factor-23 and urinary fractional excretion of calcium (FEca) and phosphorus (FEphos). We examined the associations of ET with each biomarker. In addition, we tested whether the adjustment for biomarkers attenuated the association of ET with lumbar BMD measured by abdominal computed tomography in a subset of 810 women.
Results:
In adjusted models, women who used ET were younger in age [62 (SD 8) vs 66 (9) y, P < .001], had lower mean serum calcium [−13 mg/dL (95% confidence interval [CI] −0.17, −0.10), P < .001] and lower FEca [−0.15% (95% CI −0.21, −0.09), P < .001]. Mean serum phosphorus was lower [−0.19 mg/dL (95% CI −0.23, −0.15), P < .001] and FEphos [0.56% (95% CI 0.16, 0.96), P = .007] was higher in women on ET. Mean 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D were higher [1.52 ng/dL (95% CI 0.57, 2.47), P = .002, and 0.26 ng/mL (95% CI 0.03, 0.48), P = .03, respectively] in women who used ET. Mean PTH and fibroblast growth factor-23 did not differ significantly by the use of ET. ET use was strongly associated with higher lumbar BMD [12.75 mg/cm3 (95% CI 7.77–17.73), P < .001]; however, mineral metabolism measures did not meaningfully alter this association.
Conclusions:
In a multiethnic cohort of postmenopausal women, ET use was associated with lower serum calcium, lower FEca, lower serum phosphorus, and higher FEphos, suggesting these associations are attributable to increased calcium intake into bone and increased urinary phosphorus excretion. ET use was also associated with greater concentrations of vitamin D metabolites. ET-associated differences in these mineral metabolism measures did not meaningfully attenuate the strong association between ET use and lumbar BMD.</description><subject>24,25-Dihydroxyvitamin D 3 - blood</subject><subject>24,25-Dihydroxyvitamin D 3 - metabolism</subject><subject>25-Hydroxyvitamin D 2 - blood</subject><subject>25-Hydroxyvitamin D 2 - metabolism</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Biomarkers - metabolism</subject><subject>Biomarkers - urine</subject><subject>Bone and Bones - diagnostic imaging</subject><subject>Bone and Bones - drug effects</subject><subject>Bone and Bones - metabolism</subject><subject>Bone Density - drug effects</subject><subject>Calcifediol - blood</subject><subject>Calcifediol - metabolism</subject><subject>Calcium - blood</subject><subject>Calcium - urine</subject><subject>Cohort Studies</subject><subject>Cross-Sectional Studies</subject><subject>Endocrine Research</subject><subject>Endocrinopathies</subject><subject>Ergocalciferols - blood</subject><subject>Ergocalciferols - metabolism</subject><subject>Estrogen Replacement Therapy</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fibroblast Growth Factors - blood</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Osteoporosis, Postmenopausal - blood</subject><subject>Osteoporosis, Postmenopausal - diagnostic imaging</subject><subject>Osteoporosis, Postmenopausal - metabolism</subject><subject>Osteoporosis, Postmenopausal - prevention & control</subject><subject>Phosphorus - blood</subject><subject>Phosphorus - urine</subject><subject>Radiography</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Vitamin D - analogs & derivatives</subject><subject>Vitamin D - blood</subject><subject>Vitamin D - metabolism</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkd9rFDEQxxdR7Fl981nyIvhwW_Nrd7M-COW42kKlxVb0LeRyk9s9s8ma7LYc_vNmubMqCIaBMMlnvjPDN8teEnxCKMFvt_qEYsJySkX5KJuRmhd5RerqcTbDmJK8rujXo-xZjFuMCecFe5odUY5rKmgxy35cOGNHcBqQN2gZh-A34NBtA0H1O-QdWiir27Gbo-vGx77xYYxzpNwaXQ0JQp9gM1o1-LBD5z503kFErUPXPg4dON-rMSqLvviUvJtk0cflzSm6Gcb17nn2xCgb4cXhPs4-ny1vF-f55dWHi8XpZa5LTFluDK8ZL0khVoQDAVPpQmDKGS4MV7qkTJQCVrgSZgUCCmZMYdJ-uCw012vOjrP3e91-XHWw1uCGoKzsQ9upsJNetfLvH9c2cuPvJBO8LgVOAm8OAsF_HyEOsmujBmuVAz9GSUqSQhSC_h_lZSFSiDqh8z2qg48xgHmYiGA5WSu3Wk7WysnahL_6c4sH-JeXCXh9AFTUypqgnG7jby4tQktWJY7vuXtvBwjxmx3vIcgGlB0aidPhZSXyqTOhKcunF5bK2L4M3Nrr0DroA8Qot34MLtn376l_AqGnzUE</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Bansal, Nisha</creator><creator>Katz, Ronit</creator><creator>de Boer, Ian H</creator><creator>Kestenbaum, Bryan</creator><creator>Siscovick, David S</creator><creator>Hoofnagle, Andrew N</creator><creator>Tracy, Russell</creator><creator>Laughlin, Gail A</creator><creator>Criqui, Michael H</creator><creator>Budoff, Mathew J</creator><creator>Li, Dong</creator><creator>Ix, Joachim H</creator><general>Endocrine Society</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QP</scope><scope>5PM</scope></search><sort><creationdate>201312</creationdate><title>Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study</title><author>Bansal, Nisha ; Katz, Ronit ; de Boer, Ian H ; Kestenbaum, Bryan ; Siscovick, David S ; Hoofnagle, Andrew N ; Tracy, Russell ; Laughlin, Gail A ; Criqui, Michael H ; Budoff, Mathew J ; Li, Dong ; Ix, Joachim H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6023-ff49346158b14e1ef7c58024305f4ac623868eb078fbe8e53ff5f092065c4cd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>24,25-Dihydroxyvitamin D 3 - blood</topic><topic>24,25-Dihydroxyvitamin D 3 - metabolism</topic><topic>25-Hydroxyvitamin D 2 - blood</topic><topic>25-Hydroxyvitamin D 2 - metabolism</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Biomarkers - metabolism</topic><topic>Biomarkers - urine</topic><topic>Bone and Bones - diagnostic imaging</topic><topic>Bone and Bones - drug effects</topic><topic>Bone and Bones - metabolism</topic><topic>Bone Density - drug effects</topic><topic>Calcifediol - blood</topic><topic>Calcifediol - metabolism</topic><topic>Calcium - blood</topic><topic>Calcium - urine</topic><topic>Cohort Studies</topic><topic>Cross-Sectional Studies</topic><topic>Endocrine Research</topic><topic>Endocrinopathies</topic><topic>Ergocalciferols - blood</topic><topic>Ergocalciferols - metabolism</topic><topic>Estrogen Replacement Therapy</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fibroblast Growth Factors - blood</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Osteoporosis, Postmenopausal - blood</topic><topic>Osteoporosis, Postmenopausal - diagnostic imaging</topic><topic>Osteoporosis, Postmenopausal - metabolism</topic><topic>Osteoporosis, Postmenopausal - prevention & control</topic><topic>Phosphorus - blood</topic><topic>Phosphorus - urine</topic><topic>Radiography</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Vitamin D - analogs & derivatives</topic><topic>Vitamin D - blood</topic><topic>Vitamin D - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bansal, Nisha</creatorcontrib><creatorcontrib>Katz, Ronit</creatorcontrib><creatorcontrib>de Boer, Ian H</creatorcontrib><creatorcontrib>Kestenbaum, Bryan</creatorcontrib><creatorcontrib>Siscovick, David S</creatorcontrib><creatorcontrib>Hoofnagle, Andrew N</creatorcontrib><creatorcontrib>Tracy, Russell</creatorcontrib><creatorcontrib>Laughlin, Gail A</creatorcontrib><creatorcontrib>Criqui, Michael H</creatorcontrib><creatorcontrib>Budoff, Mathew J</creatorcontrib><creatorcontrib>Li, Dong</creatorcontrib><creatorcontrib>Ix, Joachim H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bansal, Nisha</au><au>Katz, Ronit</au><au>de Boer, Ian H</au><au>Kestenbaum, Bryan</au><au>Siscovick, David S</au><au>Hoofnagle, Andrew N</au><au>Tracy, Russell</au><au>Laughlin, Gail A</au><au>Criqui, Michael H</au><au>Budoff, Mathew J</au><au>Li, Dong</au><au>Ix, Joachim H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2013-12</date><risdate>2013</risdate><volume>98</volume><issue>12</issue><spage>4890</spage><epage>4898</epage><pages>4890-4898</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Background:
Estrogen therapy (ET) is associated with lower serum calcium and phosphorus concentrations and is known to increase bone mineral density (BMD). Other biomarkers of mineral metabolism may help understand the biological basis of these actions.
Methods:
We studied 2767 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis, 862 (31%) of whom were using ET. We measured serum concentrations of calcium, phosphorus, 25-hydroxyvitamin D, 24,25-dihydoxyvitamin D, and fibroblast growth factor-23 and urinary fractional excretion of calcium (FEca) and phosphorus (FEphos). We examined the associations of ET with each biomarker. In addition, we tested whether the adjustment for biomarkers attenuated the association of ET with lumbar BMD measured by abdominal computed tomography in a subset of 810 women.
Results:
In adjusted models, women who used ET were younger in age [62 (SD 8) vs 66 (9) y, P < .001], had lower mean serum calcium [−13 mg/dL (95% confidence interval [CI] −0.17, −0.10), P < .001] and lower FEca [−0.15% (95% CI −0.21, −0.09), P < .001]. Mean serum phosphorus was lower [−0.19 mg/dL (95% CI −0.23, −0.15), P < .001] and FEphos [0.56% (95% CI 0.16, 0.96), P = .007] was higher in women on ET. Mean 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D were higher [1.52 ng/dL (95% CI 0.57, 2.47), P = .002, and 0.26 ng/mL (95% CI 0.03, 0.48), P = .03, respectively] in women who used ET. Mean PTH and fibroblast growth factor-23 did not differ significantly by the use of ET. ET use was strongly associated with higher lumbar BMD [12.75 mg/cm3 (95% CI 7.77–17.73), P < .001]; however, mineral metabolism measures did not meaningfully alter this association.
Conclusions:
In a multiethnic cohort of postmenopausal women, ET use was associated with lower serum calcium, lower FEca, lower serum phosphorus, and higher FEphos, suggesting these associations are attributable to increased calcium intake into bone and increased urinary phosphorus excretion. ET use was also associated with greater concentrations of vitamin D metabolites. ET-associated differences in these mineral metabolism measures did not meaningfully attenuate the strong association between ET use and lumbar BMD.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>24092825</pmid><doi>10.1210/jc.2013-2286</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2013-12, Vol.98 (12), p.4890-4898 |
| issn | 0021-972X 1945-7197 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3849680 |
| source | MEDLINE; Journals@Ovid Complete; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | 24,25-Dihydroxyvitamin D 3 - blood 24,25-Dihydroxyvitamin D 3 - metabolism 25-Hydroxyvitamin D 2 - blood 25-Hydroxyvitamin D 2 - metabolism Aged Aged, 80 and over Biological and medical sciences Biomarkers - blood Biomarkers - metabolism Biomarkers - urine Bone and Bones - diagnostic imaging Bone and Bones - drug effects Bone and Bones - metabolism Bone Density - drug effects Calcifediol - blood Calcifediol - metabolism Calcium - blood Calcium - urine Cohort Studies Cross-Sectional Studies Endocrine Research Endocrinopathies Ergocalciferols - blood Ergocalciferols - metabolism Estrogen Replacement Therapy Feeding. Feeding behavior Female Fibroblast Growth Factors - blood Fundamental and applied biological sciences. Psychology Humans Medical sciences Middle Aged Osteoporosis, Postmenopausal - blood Osteoporosis, Postmenopausal - diagnostic imaging Osteoporosis, Postmenopausal - metabolism Osteoporosis, Postmenopausal - prevention & control Phosphorus - blood Phosphorus - urine Radiography Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Vitamin D - analogs & derivatives Vitamin D - blood Vitamin D - metabolism |
| title | Influence of Estrogen Therapy on Calcium, Phosphorus, and Other Regulatory Hormones in Postmenopausal Women: The MESA Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T11%3A44%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Influence%20of%20Estrogen%20Therapy%20on%20Calcium,%20Phosphorus,%20and%20Other%20Regulatory%20Hormones%20in%20Postmenopausal%20Women:%20The%20MESA%20Study&rft.jtitle=The%20journal%20of%20clinical%20endocrinology%20and%20metabolism&rft.au=Bansal,%20Nisha&rft.date=2013-12&rft.volume=98&rft.issue=12&rft.spage=4890&rft.epage=4898&rft.pages=4890-4898&rft.issn=0021-972X&rft.eissn=1945-7197&rft.coden=JCEMAZ&rft_id=info:doi/10.1210/jc.2013-2286&rft_dat=%3Cproquest_pubme%3E1611618582%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1465865889&rft_id=info:pmid/24092825&rfr_iscdi=true |