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Fracture risk in perimenopausal women treated with beta-blockers.
Calcif Tissue Int. 2004 Nov; 75(5):365-72.CT

Abstract

beta2-Adrenergic receptors have been identified on human osteoblastic and osteoclastic cells, raising the question of a sympathetic regulation of bone metabolism. We investigated effects of treatment with beta-adrenergic receptor antagonists (beta-blockers) on bone turnover, bone mineral density (BMD), and fracture risk. Within the Danish Osteoporosis Prevention Study (DOPS) a population based, comprehensive cohort study of 2016 perimenopausal women, associations between treatment with beta-blockers and bone turnover and BMD were assessed in a cross-sectional design at the start of study. Moreover, in a nested case-control design, fracture risk during the subsequent 5 years was assessed in relation to treatment with beta-blockers at baseline. Multiple regression- and logistic regression-analyses were performed. Treatment with beta-blockers was associated with a threefold increased fracture risk (OR(adj) 3.3; 95% CI: 1.1-9.4). Analyses on duration of treatment showed that women who had been treated for more than 8 years had a higher fracture risk (OR(adj) 5.3; 95% CI: 1.1-26.3) than those treated for less than 8 years (OR(adj) 2.4; 95% CI: 0.6-9.5). In addition, cross-sectional data showed 20% lower serum osteocalcin levels (an osteoblastic marker of bone formation) in women treated with beta-blockers compared to untreated women (P < 0.001), whereas BMD at the lumbar spine and femoral neck did not differ between groups. beta-Blockers may decrease the activity of bone-forming cells and thereby increase fracture risk. However, confirmative studies and studies exploring mechanisms of action are needed.

Authors+Show Affiliations

Dept. of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. rejnmark@post6.tele.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

15592792

Citation

Rejnmark, Lars, et al. "Fracture Risk in Perimenopausal Women Treated With Beta-blockers." Calcified Tissue International, vol. 75, no. 5, 2004, pp. 365-72.
Rejnmark L, Vestergaard P, Kassem M, et al. Fracture risk in perimenopausal women treated with beta-blockers. Calcif Tissue Int. 2004;75(5):365-72.
Rejnmark, L., Vestergaard, P., Kassem, M., Christoffersen, B. R., Kolthoff, N., Brixen, K., & Mosekilde, L. (2004). Fracture risk in perimenopausal women treated with beta-blockers. Calcified Tissue International, 75(5), 365-72.
Rejnmark L, et al. Fracture Risk in Perimenopausal Women Treated With Beta-blockers. Calcif Tissue Int. 2004;75(5):365-72. PubMed PMID: 15592792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fracture risk in perimenopausal women treated with beta-blockers. AU - Rejnmark,Lars, AU - Vestergaard,Peter, AU - Kassem,Moustapha, AU - Christoffersen,Bo Rud, AU - Kolthoff,Niels, AU - Brixen,Kim, AU - Mosekilde,Leif, Y1 - 2004/08/12/ PY - 2003/09/07/received PY - 2004/03/29/accepted PY - 2004/12/14/pubmed PY - 2005/4/22/medline PY - 2004/12/14/entrez SP - 365 EP - 72 JF - Calcified tissue international JO - Calcif. Tissue Int. VL - 75 IS - 5 N2 - beta2-Adrenergic receptors have been identified on human osteoblastic and osteoclastic cells, raising the question of a sympathetic regulation of bone metabolism. We investigated effects of treatment with beta-adrenergic receptor antagonists (beta-blockers) on bone turnover, bone mineral density (BMD), and fracture risk. Within the Danish Osteoporosis Prevention Study (DOPS) a population based, comprehensive cohort study of 2016 perimenopausal women, associations between treatment with beta-blockers and bone turnover and BMD were assessed in a cross-sectional design at the start of study. Moreover, in a nested case-control design, fracture risk during the subsequent 5 years was assessed in relation to treatment with beta-blockers at baseline. Multiple regression- and logistic regression-analyses were performed. Treatment with beta-blockers was associated with a threefold increased fracture risk (OR(adj) 3.3; 95% CI: 1.1-9.4). Analyses on duration of treatment showed that women who had been treated for more than 8 years had a higher fracture risk (OR(adj) 5.3; 95% CI: 1.1-26.3) than those treated for less than 8 years (OR(adj) 2.4; 95% CI: 0.6-9.5). In addition, cross-sectional data showed 20% lower serum osteocalcin levels (an osteoblastic marker of bone formation) in women treated with beta-blockers compared to untreated women (P < 0.001), whereas BMD at the lumbar spine and femoral neck did not differ between groups. beta-Blockers may decrease the activity of bone-forming cells and thereby increase fracture risk. However, confirmative studies and studies exploring mechanisms of action are needed. SN - 0171-967X UR - https://www.unboundmedicine.com/medline/citation/15592792/Fracture_risk_in_perimenopausal_women_treated_with_beta_blockers_ L2 - https://dx.doi.org/10.1007/s00223-004-0222-x DB - PRIME DP - Unbound Medicine ER -