Transdermal oestrogen therapy protects postmenopausal liver transplant women from osteoporosis.: A 2-year follow-up study

Background/Aims: Hormone replacement therapy (HRT) prevents osteoporosis in postmenopausal women by inhibiting bone resorption, but the benefits of oestrogen therapy in liver transplant patients have not been studied. Methods: The effect of transdermal HRT was studied in 33 postmenopausal liver transplant women. The main outcome measure was the change in bone mineral density (BMD) which was measured annually for 2 years. The effect on bone turnover was studied by assessment of the serum aminoterminal propeptide of type I procollagen (PINP). Results: The mean lumbar BMD increased from 0.816 at baseline to 0.858 and to 0.878 g/cm(2) (P < 0.001) after 1 and 2 years of therapy, respectively. The BMD of the femoral neck increased from 0.665 to 0.690 g/cm(2) (P < 0.006). During the first and second years, the mean BMD of the lumbar spine increased hy 5.3 and 1.2%, while that of the femoral neck increased by 3.3 and 1.2%, After 2 years of HRT, only one-fifth of the patients had osteoporosis, whereas over half of the women had osteoporosis at baseline. The median serum PINP decreased by 47% at 1 year and remained decreased at 2 years compared with baseline levels. Conclusion: Transdermal HRT decreased the turnover rate of mineralized bone matrix. Transplant women responded with increased BMD, just like healthy postmenopausal women. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.