Baseline serum estradiol and fracture reduction during treatment with hormone therapy: The Women's Health Initiative randomized trial

J. A. Cauley, A. Z. Lacroix, J. A. Robbins, J. Larson, R. Wallace, J. Wactawski-Wende, Z. Chen, D. C. Bauer, S. R. Cummings, R. Jackson

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Introduction: The purpose of the study was to test the hypothesis that the reduction in fractures with hormone therapy (HT) is greater in women with lower estradiol levels. Methods: We conducted a nested case-control study within the Women's Health Initiative HT Trials. The sample included 231 hip fracture case-control pairs and a random sample of 519 all fracture case-control pairs. Cases and controls were matched for age, ethnicity, randomization date, fracture history, and hysterectomy status. Hormones were measured prior to randomization. Incident cases of fracture were identified over an average follow-up of 6.53 years. Results: There was no evidence that the effect of HT on fracture differed by baseline estradiol (E2) or sex hormone binding globulin (SHBG). Across all quartiles of E2 and SHBG, women randomized to HT had about a 50% lower risk of fracture, including hip fracture, compared to placebo. Conclusion: The effect of HT on fracture reduction is independent of estradiol and SHBG levels.

Original languageEnglish (US)
Pages (from-to)167-177
Number of pages11
JournalOsteoporosis International
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Fracture
  • Hormone therapy
  • Sex steroid hormones
  • Women's Health Initiative

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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    Cauley, J. A., Lacroix, A. Z., Robbins, J. A., Larson, J., Wallace, R., Wactawski-Wende, J., Chen, Z., Bauer, D. C., Cummings, S. R., & Jackson, R. (2010). Baseline serum estradiol and fracture reduction during treatment with hormone therapy: The Women's Health Initiative randomized trial. Osteoporosis International, 21(1), 167-177. https://doi.org/10.1007/s00198-009-0953-7