Robert R. Recker, MD; Robert P. Heaney, MD; K. Michael Davies, PhD
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Recker RR, Heaney RP, Davies KM. Effect of Low-Dose Continuous Estrogen and Progesterone Therapy with Calcium and Vitamin D on Bone in Elderly Women. Ann Intern Med. 2000;132:245. doi: 10.7326/0003-4819-132-3-200002010-00016
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Published: Ann Intern Med. 2000;132(3):245.
Lafita and Garcia question the usefulness of dual-energy x-ray absorptiometry measurements of bone mineral density (BMD) in the identification of persons at risk for fracture. In point of fact, BMD is the most powerful measurable determinant of risk for fracture available today. The relative risk for fracture with each standard deviation reduction in BMD is 1.5 to 2.6 (1). Furthermore, as far as we know, antifracture efficacy has not been demonstrated for any agent in the absence of at least modest increases in BMD. Although resorption markers such as urinary pyridinolines and N-telopeptide are predictors of fracture, they are not as powerful as BMD itself (2, 3). We measured urinary hydroxyproline excretion in this study and found the expected changes in response to HRT. In our experience, urinary hydroxyproline measurement is as good as or better than the newer markers as an index of bone resorption. Its drawback is that it is technically difficult and time-consuming.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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