This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khosla, S. Articles by Riggs, B. L. Search for Related Content PubMed PubMed Citation Articles by Khosla, S. Articles by Riggs, B. L.

Effects of Age and Estrogen Status on Serum Parathyroid Hormone Levels and Biochemical Markers of Bone Turnover in Women: A Population-Based Study¹

Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine (S.K., B.L.R.), the Sections of Biostatistics (E.J.A.) and Clinical Epidemiology (L.J.M.), Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905

Address all correspondence and requests for reprints to: Sundeep Khosla, M.D., Mayo Clinic, 200 First Street SW, 5–164 West Joseph, Rochester, Minnesota 55905.

Although estrogen deficiency is responsible for the increase in bone turnover in early postmenopausal women, age-related factors, such as the progressive increase in serum PTH levels, are believed to be responsible for the increase in bone turnover in elderly women. Whether estrogen deficiency continues to play a role, either directly or indirectly, in the pathogenesis of the increased bone turnover in elderly women remains unclear. Thus, we measured serum PTH, markers of bone turnover, and serum sex steroid levels in a population-based sample of 351 women (age range, 21–94 yr), which included 47 postmenopausal women who were receiving long term estrogen replacement therapy.

Serum PTH increased as a function of age when the premenopausal women and the estrogen-deficient postmenopausal women were analyzed together (r = 0.35; P < 0.001). By contrast, this age-related increase in serum PTH was eliminated in the postmenopausal women receiving long term estrogen therapy, which also resulted in a similar suppression of markers of bone formation and resorption in both the early (20 yr) and late (>20 yr) postmenopausal women. By multivariate analysis, serum 25-hydroxyvitamin D levels were highly predictive of serum PTH levels regardless of menopausal status, whereas serum estrone levels were predictive of markers of bone resorption in the postmenopausal women. We conclude that estrogen deficiency may be responsible not only for the increase in bone turnover in early postmenopausal women, but also indirectly for the secondary hyperparathyroidism and increase in bone turnover found in late postmenopausal women. Residual serum estrogen levels are important determinants of bone resorption in postmenopausal women.

This article has been cited by other articles:

				A. J. Felsenfeld, M. Rodriguez, and E. Aguilera-Tejero Dynamics of Parathyroid Hormone Secretion in Health and Secondary Hyperparathyroidism Clin. J. Am. Soc. Nephrol., November 1, 2007; 2(6): 1283 - 1305. [Abstract] [Full Text] [PDF]

				I. Titon, A. Cailleux-Bounacer, J. P. Basuyau, H. Lefebvre, A. Savoure, and J. M. Kuhn Evaluation of a standardized short-time calcium suppression test in healthy subjects: interest for the diagnosis of primary hyperparathyroidism Eur. J. Endocrinol., September 1, 2007; 157(3): 351 - 357. [Abstract] [Full Text] [PDF]

				Y. Zhang, W.-P. Lai, C.-F. Wu, M. J. Favus, P.-C. Leung, and M.-S. Wong Ovariectomy worsens secondary hyperparathyroidism in mature rats during low-Ca diet Am J Physiol Endocrinol Metab, March 1, 2007; 292(3): E723 - E731. [Abstract] [Full Text] [PDF]

				A. A. Fisher, E. K. Southcott, W. Srikusalanukul, M. W. Davis, P. E. Hickman, J. M. Potter, and P. N. Smith Relationships between Myocardial Injury, All-cause Mortality, Vitamin D, PTH, and Biochemical Bone Turnover Markers in Older Patients with Hip Fractures Ann. Clin. Lab. Sci., January 1, 2007; 37(3): 222 - 232. [Abstract] [Full Text] [PDF]

				J. F Aloia, S. A Talwar, S. Pollack, M. Feuerman, and J. K Yeh Optimal vitamin D status and serum parathyroid hormone concentrations in African American women. Am. J. Clinical Nutrition, September 1, 2006; 84(3): 602 - 609. [Abstract] [Full Text] [PDF]

				D. S. Perrien, S. J. Achenbach, S. E. Bledsoe, B. Walser, L. J. Suva, S. Khosla, and D. Gaddy Bone Turnover across the Menopause Transition: Correlations with Inhibins and Follicle-Stimulating Hormone J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1848 - 1854. [Abstract] [Full Text] [PDF]

				Y. Sato, M. Kaji, N. Metoki, K. Satoh, and J. Iwamoto Does compensatory hyperparathyroidism predispose to ischemic stroke? Neurology, February 25, 2003; 60(4): 626 - 629. [Abstract] [Full Text] [PDF]

				P. Taxel, P. M. Fall, P. C. Albertsen, R. D. Dowsett, M. Trahiotis, J. Zimmerman, C. Ohannessian, and L. G. Raisz The Effect of Micronized Estradiol on Bone Turnover and Calciotropic Hormones in Older Men Receiving Hormonal Suppression Therapy for Prostate Cancer J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 4907 - 4913. [Abstract] [Full Text] [PDF]

				C. Tannenbaum, J. Clark, K. Schwartzman, S. Wallenstein, R. Lapinski, D. Meier, and M. Luckey Yield of Laboratory Testing to Identify Secondary Contributors to Osteoporosis in Otherwise Healthy Women J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4431 - 4437. [Abstract] [Full Text] [PDF]

				B. L. Riggs, S. Khosla, and L. J. Melton III Sex Steroids and the Construction and Conservation of the Adult Skeleton Endocr. Rev., June 1, 2002; 23(3): 279 - 302. [Abstract] [Full Text] [PDF]

				U. S. Masiukiewicz, M. Mitnick, B. I. Gulanski, and K. L. Insogna Evidence that the IL-6/IL-6 Soluble Receptor Cytokine System Plays a Role in the Increased Skeletal Sensitivity to PTH in Estrogen-Deficient Women J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2892 - 2898. [Abstract] [Full Text] [PDF]

				J. Mei, S. S. C. Yeung, and A. W. C. Kung High Dietary Phytoestrogen Intake Is Associated with Higher Bone Mineral Density in Postmenopausal but Not Premenopausal Women J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5217 - 5221. [Abstract] [Full Text] [PDF]

				P. Lips Vitamin D Deficiency and Secondary Hyperparathyroidism in the Elderly: Consequences for Bone Loss and Fractures and Therapeutic Implications Endocr. Rev., August 1, 2001; 22(4): 477 - 501. [Abstract] [Full Text] [PDF]

				S. S. Harris, E. Soteriades, and B. Dawson-Hughes Secondary Hyperparathyroidism and Bone Turnover in Elderly Blacks and Whites J. Clin. Endocrinol. Metab., August 1, 2001; 86(8): 3801 - 3804. [Abstract] [Full Text] [PDF]

				U. S. Masiukiewicz, M. Mitnick, A. B. Grey, and K. L. Insogna Estrogen Modulates Parathyroid Hormone-Induced Interleukin-6 Production in Vivo and in Vitro Endocrinology, July 1, 2000; 141(7): 2526 - 2531. [Abstract] [Full Text] [PDF]

				J. R. Center, T. V. Nguyen, P. N. Sambrook, and J. A. Eisman Hormonal and Biochemical Parameters in the Determination of Osteoporosis in Elderly Men J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3626 - 3635. [Abstract] [Full Text] [PDF]

				M. S. LeBoff, L. Kohlmeier, S. Hurwitz, J. Franklin, J. Wright, and J. Glowacki Occult Vitamin D Deficiency in Postmenopausal US Women With Acute Hip Fracture JAMA, April 28, 1999; 281(16): 1505 - 1511. [Abstract] [Full Text] [PDF]

				S. Khosla, L. J. Melton III, E. J. Atkinson, W. M. O’Fallon, G. G. Klee, and B. L. Riggs Relationship of Serum Sex Steroid Levels and Bone Turnover Markers with Bone Mineral Density in Men and Women: A Key Role for Bioavailable Estrogen J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2266 - 2274. [Abstract] [Full Text]

				I. Gorai, Y. Taguchi, O. Chaki, R. K. M. Nakayama, B. C. Yang, S. Yokota, and H. Minaguchi Serum Soluble Interleukin-6 Receptor and Biochemical Markers of Bone Metabolism Show Significant Variations During the Menstrual Cycle J. Clin. Endocrinol. Metab., February 1, 1998; 83(2): 326 - 332. [Abstract] [Full Text]

				S. Khosla Idiopathic Osteoporosis: Is the Osteoblast to Blame?--Author's Response J. Clin. Endocrinol. Metab., February 1, 1998; 83(2): 716a - 716. [Full Text]