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SOSTOYaNIE KOSTNOY TKANI I RISK RAZVITIYa OSTEOPOROZA U ZhENShchIN V STADII POLNOY REMISSIIBOLEZNI ITsENKO-KUShINGA NA FONE FIZIOLOGIChESKOYMENOPAUZY

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Abstract


It is well known that clinical signs of endogenous hypercorticism including secondary osteoporosis rapidly reverse on the base of hormonal remission after radiosurgical treatment of Cushing's disease (CD). The aim of the study was to assess BMD and bone turnover biochemical markers in postmenopausal women with complete CD-remission.
We examined 43 women aged 38-67 years in physiological postmenopause who had a complete long-term hormonal CD-remission for at least 2 years (11±6,8 years in average) after combine treatment with hemiadrenalectomy and radiosurgery. Control group comprised 98 healthy postmenopausal women at the same age and postmenopausal age.
Our main findings were BMD in postmenopausal CD-patients was higher vs. controls in lumbar spine (1,233±0,17 vs. 1,146±0,20 g/cm2, p<0,05), trochanter (0,873±0,15 vs. 0,809±0,15 g/cm2, p<0,05) and total proximal femur (1,067±0,16 vs. 0,949±0,21 g/cm2, p<0,01). Frequency of normal BMD was significantly higher in spine (93%), trochanter (93%), total proximal femur (93%) and distal forearm (81%) in CD-group vs. control (62%, 76%, 77% and 59% accordingly, p<0,05). There was also revealed a lower frequency of osteopenia in spine (14%), trochanter (7%) and distal forearm (14%) in CD-group vs. control (32%, 23% and 33% accordingly, p<0,05), although incidence of vertebral deformities were more in CD-group (37%) vs. control (18%, p<0,05). We found significantly lower levels of CTx (p<0,001) and osteocalcin (p<0,01) in CD-patients vs. controls. A maximal BMD gain was observed in patients with CD remission about 4-5 years and BMD significantly decreased in women with CD-remission more than 12 years. CD-women with postmenopausal age 2-10 years had significantly higher BMD vs. associate control postmenopausal women. Marked BMD lowering was observed in CD-women only after 10 years of menopause. Age, postmenopausal age, low body weight and duration of remission were evaluated as main risk factors for osteoporosis in women with complete CD-remission.
Our result demonstrate that postmenopausal women with complete CD-remission have higher BMD and lower bone turnover than healthy postmenopausal women of the same age and maximal increase in BMD is observed at about 5 years of complete CD-remission.

L A MARChENKOVA

A V DREVAL'

E Yu POLYaKOVA

R S TIShENINA

N M MYLOV

I P ERMAKOVA

I A PRONChENKO

V P BUZULINA

M P RUBIN

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Copyright (c) 2007 MARChENKOVA L.A., DREVAL' A.V., POLYaKOVA E.Y., TIShENINA R.S., MYLOV N.M., ERMAKOVA I.P., PRONChENKO I.A., BUZULINA V.P., RUBIN M.P.

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