Biologic effects of equilin sulfate in postmenopausal women

252 by kinetic, densitometric, histomorphometric and biochemical studies performed before and during treatment. Two patients developed hPTH 1-34 binding in their plasma during treatment: this was presumed to be due to the development of antibodies. The remainder, instead of increasing their indices of bone turnover as judged by iliac bone histomorphometry, were found to have consistent reductions in trabecular resorption surfaces. The other indices of bone formation and resorption measured showed no change or comparable reductions. The small increases seen in total body calcium were consistent with ‘in-fiig’ of deleted basic multicellular units (BMUs). Because there is no evidence that calcitriol alone causes comparable reductions in activation of bone remodelling in osteoporosis, interruption of treatment with hPTH 1-34 after 7 days may have led to a failure of the activation mechanism to proceed to the resorption stage, with a consequent overall reduction in remodelling activity. This type of treatment regime, with its calcitonin-like effect, might be effective in reducing net bone loss due to imbalance between bone formation and resorption at the BMU level, particularly in patients with increased numbers of BMUs (‘high turnover’ osteoporosis). However, it proved a less promising regime than daily injections of PTH l-34 or sodium fluoride plus calcium therapy for the substantial reversal of axial trabecular bone loss in patients able to respond to these therapies.

Biobglc effects of quitin sulfate in postmenopausal women Lobo RA; Nguyen HN, Eggena P; Brenner PF University of Southern CaQfornia School of Medicine, Los Angeles County, University of Southern California Medical Center. Women’s Hospital, Los Angeles, CA RW33, United States of America FERTIL. STERIL.; 49/2 (234-238)/1988/ In order to determine the relative potency of equilin sulfate (EqS). a major constituent of conjugated equine estrogens, 15 women received oral doses of EqS (0.15, 0.31, and 0.625 mg) for 25 days. Doses of 0.31 and 0.625 mg significantly stimulated hepatic globulins. This stimulatory effect ranged from being 1.5 to 8 times greater than the effects of comparable doses of estrone sulfate and conjugated equine estrogens. A significant stimulation in high-density lipoprotein-cholesterol occurred with as little as 01.5 mg of EqS. Elevations in the high-density lipoprotein/low-density lipoprotein cholesterol ratio occurred with EqS, which resulted in an approximately Cfold greater response than that achieved with comparable doses of conjugated equine estrogens. The fasting urinary calcium/creatinine ratio was only significantly lowered with 0.625 mg of EqS and was less potent than conjugated equine estrogens in this regard. It is concluded that EqS is a potent estrogen that contributes significantly to the hepatic stimulatory effects of conjugated equine estrogens. These data also provide support for the suggestion that there may be a dissociation in potency between estrogenic effects on liver and bone.

Comparisons among methods of measuring bone mass and relationship to severity of vertebral fractures in osteoporo!& Ott SM; Kilcoyne RF; Chesnut CH III Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, United States of America J. CLIN. ENDQCRINOL. METAB.; 66/3 (501-507)/1988/ Several techniques are now available for quantitation of bone mass. including total body calcium by neutron activation analysis (TBC). single and dual photon absorptiometry at the radius and spine, respectively (SPA and DPA), quantitative computed tomography of the spine (QCT), and cancellous bone volume from iliac crest bone biopsies. The aims of this study were to assess the correlation among these techniques and to determine if bone mass correlated with height loss or the severity of vertebral fractures in osteoporotic women. These measurements were performed in the same group of women (n = 122) with postmenopausal osteoporosis. TBC, SPA, DPA, and QCT correlated significantly with each other (r = 0.33-0.76). The correlation between QCT and DPA improved significantly (r = 0.33-0.57; P = 0.02) when integral QCT was used instead of the usual QCT of the central vertebra. The correlation was not improved by expressing DPA in different dimensions, but