Biopsychosocial variables associated with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate in adolescents: Adolescents who lost 5% or more from baseline vs. those who lost less than 5%

Zeev Harel, Kevin Wolter, Melanie A. Gold, Barbara Cromer, Margaret Stager, Christine Cole Johnson, Robert Brown, Ann Bruner, Susan M. Coupey, Paige Hertweck, Henry Bone, Ronald Burkman, Anita Nelson, Sharon Marshall, Laura K. Bachrach

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: It is unclear why some adolescents experience substantial bone mineral density (BMD) loss, while others experience a minimal decrease during depot medroxyprogesterone acetate (DMPA) use. We examined biopsychosocial factors in adolescents who experienced ≥5% BMD loss from baseline compared with adolescents who experienced <5% BMD loss during DMPA use. Study Design: A multicenter, prospective, nonrandomized study of 181 female adolescents who initiated DMPA for contraception was conducted. BMD (by dual-energy X-ray absorptiometry) and serum estradiol were measured at initiation and every 6 months for 240 weeks of DMPA use. Results: Half of participants experienced BMD loss of ≥5% from baseline at the hip, and a quarter experienced BMD loss of ≥5% at the lumbar spine (BMD substantial losers, SL). Hip and lumbar spine BMD-SL received a significantly greater number of DMPA injections than non-SL (p<.001). Decreased estradiol levels did not statistically differ between BMD loss subgroups. Hip BMD-SL had significantly lower baseline body mass index (BMI) than non-SL (p=.002), and there was an inverse relationship between weight gain and degree of BMD loss. Mean calcium intake was significantly lower (p<.05) in hip BMD-SL, and reported alcohol use was significantly higher (p<.05) in lumbar spine BMD-SL compared with non-SL. Conclusions: BMD loss of ≥5% was more common at the hip than at the lumbar spine among adolescents using DMPA. Decreased serum estradiol levels did not correlate with magnitude of BMD loss. Lower BMI and calcium intake and greater alcohol use were associated with greater BMD loss in adolescents using DMPA.

Original languageEnglish (US)
Pages (from-to)503-512
Number of pages10
JournalContraception
Volume82
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Medroxyprogesterone Acetate
Bone Density
Spine
Pelvic Bones
Hip
Estradiol
Body Mass Index
Alcohols
Calcium
Photon Absorptiometry
Serum
Contraception

Keywords

  • Adolescents
  • Bone markers
  • Bone mineral density
  • Female
  • Medroxyprogesterone acetate (DMPA, Depo-Provera®)

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Biopsychosocial variables associated with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate in adolescents : Adolescents who lost 5% or more from baseline vs. those who lost less than 5%. / Harel, Zeev; Wolter, Kevin; Gold, Melanie A.; Cromer, Barbara; Stager, Margaret; Johnson, Christine Cole; Brown, Robert; Bruner, Ann; Coupey, Susan M.; Hertweck, Paige; Bone, Henry; Burkman, Ronald; Nelson, Anita; Marshall, Sharon; Bachrach, Laura K.

In: Contraception, Vol. 82, No. 6, 12.2010, p. 503-512.

Research output: Contribution to journalArticle

Harel, Zeev ; Wolter, Kevin ; Gold, Melanie A. ; Cromer, Barbara ; Stager, Margaret ; Johnson, Christine Cole ; Brown, Robert ; Bruner, Ann ; Coupey, Susan M. ; Hertweck, Paige ; Bone, Henry ; Burkman, Ronald ; Nelson, Anita ; Marshall, Sharon ; Bachrach, Laura K. / Biopsychosocial variables associated with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate in adolescents : Adolescents who lost 5% or more from baseline vs. those who lost less than 5%. In: Contraception. 2010 ; Vol. 82, No. 6. pp. 503-512.
@article{aad973bcc9654a228fe59f9d809d4975,
title = "Biopsychosocial variables associated with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate in adolescents: Adolescents who lost 5{\%} or more from baseline vs. those who lost less than 5{\%}",
abstract = "Background: It is unclear why some adolescents experience substantial bone mineral density (BMD) loss, while others experience a minimal decrease during depot medroxyprogesterone acetate (DMPA) use. We examined biopsychosocial factors in adolescents who experienced ≥5{\%} BMD loss from baseline compared with adolescents who experienced <5{\%} BMD loss during DMPA use. Study Design: A multicenter, prospective, nonrandomized study of 181 female adolescents who initiated DMPA for contraception was conducted. BMD (by dual-energy X-ray absorptiometry) and serum estradiol were measured at initiation and every 6 months for 240 weeks of DMPA use. Results: Half of participants experienced BMD loss of ≥5{\%} from baseline at the hip, and a quarter experienced BMD loss of ≥5{\%} at the lumbar spine (BMD substantial losers, SL). Hip and lumbar spine BMD-SL received a significantly greater number of DMPA injections than non-SL (p<.001). Decreased estradiol levels did not statistically differ between BMD loss subgroups. Hip BMD-SL had significantly lower baseline body mass index (BMI) than non-SL (p=.002), and there was an inverse relationship between weight gain and degree of BMD loss. Mean calcium intake was significantly lower (p<.05) in hip BMD-SL, and reported alcohol use was significantly higher (p<.05) in lumbar spine BMD-SL compared with non-SL. Conclusions: BMD loss of ≥5{\%} was more common at the hip than at the lumbar spine among adolescents using DMPA. Decreased serum estradiol levels did not correlate with magnitude of BMD loss. Lower BMI and calcium intake and greater alcohol use were associated with greater BMD loss in adolescents using DMPA.",
keywords = "Adolescents, Bone markers, Bone mineral density, Female, Medroxyprogesterone acetate (DMPA, Depo-Provera{\circledR})",
author = "Zeev Harel and Kevin Wolter and Gold, {Melanie A.} and Barbara Cromer and Margaret Stager and Johnson, {Christine Cole} and Robert Brown and Ann Bruner and Coupey, {Susan M.} and Paige Hertweck and Henry Bone and Ronald Burkman and Anita Nelson and Sharon Marshall and Bachrach, {Laura K.}",
year = "2010",
month = "12",
doi = "10.1016/j.contraception.2010.04.022",
language = "English (US)",
volume = "82",
pages = "503--512",
journal = "Contraception",
issn = "0010-7824",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Biopsychosocial variables associated with substantial bone mineral density loss during the use of depot medroxyprogesterone acetate in adolescents

T2 - Adolescents who lost 5% or more from baseline vs. those who lost less than 5%

AU - Harel, Zeev

AU - Wolter, Kevin

AU - Gold, Melanie A.

AU - Cromer, Barbara

AU - Stager, Margaret

AU - Johnson, Christine Cole

AU - Brown, Robert

AU - Bruner, Ann

AU - Coupey, Susan M.

AU - Hertweck, Paige

AU - Bone, Henry

AU - Burkman, Ronald

AU - Nelson, Anita

AU - Marshall, Sharon

AU - Bachrach, Laura K.

PY - 2010/12

Y1 - 2010/12

N2 - Background: It is unclear why some adolescents experience substantial bone mineral density (BMD) loss, while others experience a minimal decrease during depot medroxyprogesterone acetate (DMPA) use. We examined biopsychosocial factors in adolescents who experienced ≥5% BMD loss from baseline compared with adolescents who experienced <5% BMD loss during DMPA use. Study Design: A multicenter, prospective, nonrandomized study of 181 female adolescents who initiated DMPA for contraception was conducted. BMD (by dual-energy X-ray absorptiometry) and serum estradiol were measured at initiation and every 6 months for 240 weeks of DMPA use. Results: Half of participants experienced BMD loss of ≥5% from baseline at the hip, and a quarter experienced BMD loss of ≥5% at the lumbar spine (BMD substantial losers, SL). Hip and lumbar spine BMD-SL received a significantly greater number of DMPA injections than non-SL (p<.001). Decreased estradiol levels did not statistically differ between BMD loss subgroups. Hip BMD-SL had significantly lower baseline body mass index (BMI) than non-SL (p=.002), and there was an inverse relationship between weight gain and degree of BMD loss. Mean calcium intake was significantly lower (p<.05) in hip BMD-SL, and reported alcohol use was significantly higher (p<.05) in lumbar spine BMD-SL compared with non-SL. Conclusions: BMD loss of ≥5% was more common at the hip than at the lumbar spine among adolescents using DMPA. Decreased serum estradiol levels did not correlate with magnitude of BMD loss. Lower BMI and calcium intake and greater alcohol use were associated with greater BMD loss in adolescents using DMPA.

AB - Background: It is unclear why some adolescents experience substantial bone mineral density (BMD) loss, while others experience a minimal decrease during depot medroxyprogesterone acetate (DMPA) use. We examined biopsychosocial factors in adolescents who experienced ≥5% BMD loss from baseline compared with adolescents who experienced <5% BMD loss during DMPA use. Study Design: A multicenter, prospective, nonrandomized study of 181 female adolescents who initiated DMPA for contraception was conducted. BMD (by dual-energy X-ray absorptiometry) and serum estradiol were measured at initiation and every 6 months for 240 weeks of DMPA use. Results: Half of participants experienced BMD loss of ≥5% from baseline at the hip, and a quarter experienced BMD loss of ≥5% at the lumbar spine (BMD substantial losers, SL). Hip and lumbar spine BMD-SL received a significantly greater number of DMPA injections than non-SL (p<.001). Decreased estradiol levels did not statistically differ between BMD loss subgroups. Hip BMD-SL had significantly lower baseline body mass index (BMI) than non-SL (p=.002), and there was an inverse relationship between weight gain and degree of BMD loss. Mean calcium intake was significantly lower (p<.05) in hip BMD-SL, and reported alcohol use was significantly higher (p<.05) in lumbar spine BMD-SL compared with non-SL. Conclusions: BMD loss of ≥5% was more common at the hip than at the lumbar spine among adolescents using DMPA. Decreased serum estradiol levels did not correlate with magnitude of BMD loss. Lower BMI and calcium intake and greater alcohol use were associated with greater BMD loss in adolescents using DMPA.

KW - Adolescents

KW - Bone markers

KW - Bone mineral density

KW - Female

KW - Medroxyprogesterone acetate (DMPA, Depo-Provera®)

UR - http://www.scopus.com/inward/record.url?scp=78249231368&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78249231368&partnerID=8YFLogxK

U2 - 10.1016/j.contraception.2010.04.022

DO - 10.1016/j.contraception.2010.04.022

M3 - Article

C2 - 21074012

AN - SCOPUS:78249231368

VL - 82

SP - 503

EP - 512

JO - Contraception

JF - Contraception

SN - 0010-7824

IS - 6

ER -