Endocrine Abstracts

Introduction: Since chronic renal failure is accompanied with bone abnormalities, the term renal osteodystrophy has become widely accepted. In women, chronic renal failure is commonly accompanied by endocrine problems that cause irregular menstruation. The majority of investigations on renal osteodystrophy, however, have not considered the potential impact of these hormonal imbalances on the etiology of the bone changes observed in these patients.

Objective: In the current study, the bone mineral metabolism in a group of young hemodialyzed women with persistent amenorrhea was assessed and contrasted with women of comparable age and menstrual cycle

Method: The study included 70 women, of which 30 had persistent amenorrhea, which is the lack of menstrual blood for more than five months, and 40 had regular menstrual cycles. All patients underwent a bone mineral density (BMD) analysis that simultaneously assessed various biochemical parameters, intact parathyroid hormone (iPTH), sexual hormone measurements including total estradiol, follicle-stimulating (FSH), and luteinizing hormone, and markers of bone resorption such as the procollagen type 1 cross-linked carboxy-terminal telopeptide (ICTP). Unpaired observations were compared using the Student’s t-test between two groups of data (two-tailed). The linear regression technique was used to compare two variables. P values below 0.04 were regarded as significant.

Result: Both groups had comparable levels of serum iPTH, calcium, and phosphorus. Amenorrheic women had greater serum levels of alkaline phosphatase. Despite being normal when compared to non-uremic women, the total serum estradiol levels in amenorrheic women was substantially lower than that of women who regularly menstruate. The amenorrheic women had considerably greater serum levels of FSH and ICTP. Compared to dialysis patients who had regular periods, the trabecular BMD in the lumbar spine was likewise considerably lower in amenorrheic women. Significant correlation was seen in the amenorrheic group between lumbar spine BMD and total estradiol levels.

Conclusion: These results demonstrated that when compared to regular menstruation women on dialysis, persistently amenorrheic young women on dialysis have reduced trabecular BMD and signs of accelerated bone resorption. It is yet to be determined how these findings may affect the course of uremic osteodystrophy in its natural state.