One‐year adolescent bone mineral density and bone formation marker changes through the use or lack of use of combined hormonal contraceptives

• Published in: Jornal de Pediatria (Versão em Português) 2019-09, Vol.95 (5), p.567-574
• Main Authors: Rizzo, Anapaula da Conceição Bisi, Goldberg, Tamara Beres Lederer, Biason, Talita Poli, Kurokawa, Cilmery Suemi, Silva, Carla Cristiane da, Corrente, José Eduardo, Nunes, Helio Rubens Carvalho
• Format: Article
• Language: Portuguese
• Subjects: Adolescentes; Adolescents; Bone density; Bone remodeling; Contraceptivos orais; Densidade óssea; Estudo prospectivo; Oral contraceptives; Osteocalcin; Osteocalcina; Prospective study; Remodelação óssea
• ISSN: 2255-5536; 2255-5536
• DOI: 10.1016/j.jpedp.2018.05.012

The objective of this study was to evaluate the effects of two low‐dose combined oral contraceptives on bone metabolism in adolescents for one year. This was a quasi‐experimental study. The adolescents were divided into three groups: oral contraceptives 1 (n=42) (20μg EE/150μg desogestrel), oral contraceptives 2 (n=66) (30μg EE/3mg drospirenone), and a control group (n=70). Adolescents underwent anthropometric assessment and densitometry (dual‐energy X‐ray). Bone age and bone formation markers (osteocalcin and bone alkaline phosphatase) were evaluated. The oral contraceptives users were evaluated again after 12 months. Linear regression analysis was used to indirectly study the effect of each additional year of chronological age on anthropometric and densitometric variables as well as on bone markers in the control group. At study entry, no significant differences were observed between the oral contraceptives 1, oral contraceptives 2, and controls in the analyzed variables. Linear regression analysis showed an increase in bone mineral density and bone mineral content for each additional year. There was a significant reduction in bone alkaline phosphatase levels; no significant difference was observed for osteocalcin in control individuals. Comparison of dual‐energy X‐ray variables at baseline and after one year showed no significant differences in the oral contraceptives 1 or oral contraceptives 2 groups. A significant reduction in bone alkaline phosphatase and osteocalcin levels was observed in both the oral contraceptives 1 and oral contraceptives 2 groups. Adolescent women gain peak bone mass during this phase of life. Two low‐dose combined oral hormonal contraceptives were associated with lower bone gain and lower bone formation markers than in untreated controls. O objetivo deste estudo foi avaliar os efeitos de dois contraceptivos orais combinados de baixa dosagem por um ano sobre o metabolismo ósseo em adolescentes. Este foi um estudo quase experimental. As adolescentes foram divididas em três grupos: contraceptivos orais 1 (n=42) (20μg de EE/150μg de desogestrel), contraceptivos orais 2 (n=66) (30μg EE/3mg de drospirenona) e grupo controle (n=70). As adolescentes foram submetidas à avaliação antropométrica e densitometria (raio-X de dupla energia). Foram avaliados a idade óssea e os marcadores de formação óssea (osteocalcina e fosfatase alcalina óssea). As usuárias de contraceptivos orais foram novamente avaliadas após 12 meses. A análise de regres