Predictors of higher bone mineral density loss and use of depot medroxyprogesterone acetate

Mahbubur Rahman, Abbey Berenson

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To identify possible predictive factors of higher bone loss, defined as at least 5%, at the spine or femoral neck, over time in depot medroxyprogesterone acetate (DMPA) users. Methods: Bone mineral density (BMD) was measured at the lumbar spine and femoral neck every 6 months in 240 white, African-American, and Hispanic women using DMPA. For the purpose of analysis, an arbitrary value of at least 5% BMD loss from the baseline value after 24 months of DMPA use at either the lumbar spine or the femoral neck was considered as higher BMD loss. Logistic regression analysis was then used to examine factors predictive of at least 5% BMD loss at either site. Results: Of the initial 240 DMPA users, 95 completed 24 months of follow-up. Forty-five of the 95 DMPA users (47.4%) had at least 5% BMD loss at the lumbar spine or femoral neck by 24 months. Multivariable logistic regression model showed that at least 5% BMD loss was associated with current smoking (adjusted odds ratio [OR] 3.88, 95% confidence interval [CI] 1.26-11.96), calcium intake (in 100 mg) (OR 0.81, 95% CI 0.65-0.99), and parity (OR 0.49, 95% CI 0.29-0.82). Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. CONCLUSION: The risk of higher BMD loss associated with DMPA use may be reduced by quitting smoking and increasing calcium intake. Having had a child is also protective.

Original languageEnglish (US)
Pages (from-to)35-40
Number of pages6
JournalObstetrics and Gynecology
Volume115
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Medroxyprogesterone Acetate
Bone Density
Femur Neck
Spine
Logistic Models
Odds Ratio
Confidence Intervals
Smoking
Calcium
Contraceptive Agents
Parity
Hispanic Americans
African Americans
Body Mass Index
Regression Analysis
Bone and Bones

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Predictors of higher bone mineral density loss and use of depot medroxyprogesterone acetate. / Rahman, Mahbubur; Berenson, Abbey.

In: Obstetrics and Gynecology, Vol. 115, No. 1, 01.2010, p. 35-40.

Research output: Contribution to journalArticle

@article{ad077cae664646eb845faea0de6ee58d,
title = "Predictors of higher bone mineral density loss and use of depot medroxyprogesterone acetate",
abstract = "Objective: To identify possible predictive factors of higher bone loss, defined as at least 5{\%}, at the spine or femoral neck, over time in depot medroxyprogesterone acetate (DMPA) users. Methods: Bone mineral density (BMD) was measured at the lumbar spine and femoral neck every 6 months in 240 white, African-American, and Hispanic women using DMPA. For the purpose of analysis, an arbitrary value of at least 5{\%} BMD loss from the baseline value after 24 months of DMPA use at either the lumbar spine or the femoral neck was considered as higher BMD loss. Logistic regression analysis was then used to examine factors predictive of at least 5{\%} BMD loss at either site. Results: Of the initial 240 DMPA users, 95 completed 24 months of follow-up. Forty-five of the 95 DMPA users (47.4{\%}) had at least 5{\%} BMD loss at the lumbar spine or femoral neck by 24 months. Multivariable logistic regression model showed that at least 5{\%} BMD loss was associated with current smoking (adjusted odds ratio [OR] 3.88, 95{\%} confidence interval [CI] 1.26-11.96), calcium intake (in 100 mg) (OR 0.81, 95{\%} CI 0.65-0.99), and parity (OR 0.49, 95{\%} CI 0.29-0.82). Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. CONCLUSION: The risk of higher BMD loss associated with DMPA use may be reduced by quitting smoking and increasing calcium intake. Having had a child is also protective.",
author = "Mahbubur Rahman and Abbey Berenson",
year = "2010",
month = "1",
doi = "10.1097/AOG.0b013e3181c4e864",
language = "English (US)",
volume = "115",
pages = "35--40",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Predictors of higher bone mineral density loss and use of depot medroxyprogesterone acetate

AU - Rahman, Mahbubur

AU - Berenson, Abbey

PY - 2010/1

Y1 - 2010/1

N2 - Objective: To identify possible predictive factors of higher bone loss, defined as at least 5%, at the spine or femoral neck, over time in depot medroxyprogesterone acetate (DMPA) users. Methods: Bone mineral density (BMD) was measured at the lumbar spine and femoral neck every 6 months in 240 white, African-American, and Hispanic women using DMPA. For the purpose of analysis, an arbitrary value of at least 5% BMD loss from the baseline value after 24 months of DMPA use at either the lumbar spine or the femoral neck was considered as higher BMD loss. Logistic regression analysis was then used to examine factors predictive of at least 5% BMD loss at either site. Results: Of the initial 240 DMPA users, 95 completed 24 months of follow-up. Forty-five of the 95 DMPA users (47.4%) had at least 5% BMD loss at the lumbar spine or femoral neck by 24 months. Multivariable logistic regression model showed that at least 5% BMD loss was associated with current smoking (adjusted odds ratio [OR] 3.88, 95% confidence interval [CI] 1.26-11.96), calcium intake (in 100 mg) (OR 0.81, 95% CI 0.65-0.99), and parity (OR 0.49, 95% CI 0.29-0.82). Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. CONCLUSION: The risk of higher BMD loss associated with DMPA use may be reduced by quitting smoking and increasing calcium intake. Having had a child is also protective.

AB - Objective: To identify possible predictive factors of higher bone loss, defined as at least 5%, at the spine or femoral neck, over time in depot medroxyprogesterone acetate (DMPA) users. Methods: Bone mineral density (BMD) was measured at the lumbar spine and femoral neck every 6 months in 240 white, African-American, and Hispanic women using DMPA. For the purpose of analysis, an arbitrary value of at least 5% BMD loss from the baseline value after 24 months of DMPA use at either the lumbar spine or the femoral neck was considered as higher BMD loss. Logistic regression analysis was then used to examine factors predictive of at least 5% BMD loss at either site. Results: Of the initial 240 DMPA users, 95 completed 24 months of follow-up. Forty-five of the 95 DMPA users (47.4%) had at least 5% BMD loss at the lumbar spine or femoral neck by 24 months. Multivariable logistic regression model showed that at least 5% BMD loss was associated with current smoking (adjusted odds ratio [OR] 3.88, 95% confidence interval [CI] 1.26-11.96), calcium intake (in 100 mg) (OR 0.81, 95% CI 0.65-0.99), and parity (OR 0.49, 95% CI 0.29-0.82). Age, race or ethnicity, previous contraceptive use, and body mass index were not associated with higher BMD loss. CONCLUSION: The risk of higher BMD loss associated with DMPA use may be reduced by quitting smoking and increasing calcium intake. Having had a child is also protective.

UR - http://www.scopus.com/inward/record.url?scp=74049109772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=74049109772&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e3181c4e864

DO - 10.1097/AOG.0b013e3181c4e864

M3 - Article

C2 - 20027031

AN - SCOPUS:74049109772

VL - 115

SP - 35

EP - 40

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 1

ER -