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Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer

BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) reduces ovarian cancer risk in BRCA1/2 mutation carriers. Premenopausal RRSO is hypothesized to increase fracture risk more than natural menopause. Elevated bone turnover markers (BTMs) might predict fracture risk. We investigated BTM levels aft...

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Autores principales: Fakkert, Ingrid E., van der Veer, Eveline, Abma, Elske Marije, Lefrandt, Joop D., Wolffenbuttel, Bruce H. R., Oosterwijk, Jan C., Slart, Riemer H. J. A., Westrik, Iris G., de Bock, Geertruida H., Mourits, Marian J. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218401/
https://www.ncbi.nlm.nih.gov/pubmed/28060958
http://dx.doi.org/10.1371/journal.pone.0169673
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author Fakkert, Ingrid E.
van der Veer, Eveline
Abma, Elske Marije
Lefrandt, Joop D.
Wolffenbuttel, Bruce H. R.
Oosterwijk, Jan C.
Slart, Riemer H. J. A.
Westrik, Iris G.
de Bock, Geertruida H.
Mourits, Marian J. E.
author_facet Fakkert, Ingrid E.
van der Veer, Eveline
Abma, Elske Marije
Lefrandt, Joop D.
Wolffenbuttel, Bruce H. R.
Oosterwijk, Jan C.
Slart, Riemer H. J. A.
Westrik, Iris G.
de Bock, Geertruida H.
Mourits, Marian J. E.
author_sort Fakkert, Ingrid E.
collection PubMed
description BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) reduces ovarian cancer risk in BRCA1/2 mutation carriers. Premenopausal RRSO is hypothesized to increase fracture risk more than natural menopause. Elevated bone turnover markers (BTMs) might predict fracture risk. We investigated BTM levels after RRSO and aimed to identify clinical characteristics associated with elevated BTMs. METHODS: Osteocalcin (OC), procollagen type I N-terminal peptide (PINP) and serum C-telopeptide of type I collagen (sCTx) were measured in 210 women ≥ 2 years after RRSO before age 53. BTM Z-scores were calculated using an existing reference cohort of age-matched women. Clinical characteristics were assessed by questionnaire. RESULTS: BTMs after RRSO were higher than age-matched reference values: median Z-scores OC 0.11, p = 0.003; PINP 0.84, p < 0.001; sCTx 0.53, p < 0.001 (compared to Z = 0). After excluding women with recent fractures or BTM interfering medication, Z-scores increased to 0.34, 1.14 and 0.88, respectively. Z-scores for OC and PINP were inversely correlated to age at RRSO. No correlation was found with fracture incidence or history of breast cancer. CONCLUSIONS: Five years after RRSO, BTMs were higher than age-matched reference values. Since elevated BTMs might predict higher fracture risk, prospective studies are required to evaluate the clinical implications of this finding.
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spelling pubmed-52184012017-01-19 Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer Fakkert, Ingrid E. van der Veer, Eveline Abma, Elske Marije Lefrandt, Joop D. Wolffenbuttel, Bruce H. R. Oosterwijk, Jan C. Slart, Riemer H. J. A. Westrik, Iris G. de Bock, Geertruida H. Mourits, Marian J. E. PLoS One Research Article BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) reduces ovarian cancer risk in BRCA1/2 mutation carriers. Premenopausal RRSO is hypothesized to increase fracture risk more than natural menopause. Elevated bone turnover markers (BTMs) might predict fracture risk. We investigated BTM levels after RRSO and aimed to identify clinical characteristics associated with elevated BTMs. METHODS: Osteocalcin (OC), procollagen type I N-terminal peptide (PINP) and serum C-telopeptide of type I collagen (sCTx) were measured in 210 women ≥ 2 years after RRSO before age 53. BTM Z-scores were calculated using an existing reference cohort of age-matched women. Clinical characteristics were assessed by questionnaire. RESULTS: BTMs after RRSO were higher than age-matched reference values: median Z-scores OC 0.11, p = 0.003; PINP 0.84, p < 0.001; sCTx 0.53, p < 0.001 (compared to Z = 0). After excluding women with recent fractures or BTM interfering medication, Z-scores increased to 0.34, 1.14 and 0.88, respectively. Z-scores for OC and PINP were inversely correlated to age at RRSO. No correlation was found with fracture incidence or history of breast cancer. CONCLUSIONS: Five years after RRSO, BTMs were higher than age-matched reference values. Since elevated BTMs might predict higher fracture risk, prospective studies are required to evaluate the clinical implications of this finding. Public Library of Science 2017-01-06 /pmc/articles/PMC5218401/ /pubmed/28060958 http://dx.doi.org/10.1371/journal.pone.0169673 Text en © 2017 Fakkert et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Fakkert, Ingrid E.
van der Veer, Eveline
Abma, Elske Marije
Lefrandt, Joop D.
Wolffenbuttel, Bruce H. R.
Oosterwijk, Jan C.
Slart, Riemer H. J. A.
Westrik, Iris G.
de Bock, Geertruida H.
Mourits, Marian J. E.
Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title_full Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title_fullStr Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title_full_unstemmed Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title_short Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer
title_sort elevated bone turnover markers after risk-reducing salpingo-oophorectomy in women at increased risk for breast and ovarian cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218401/
https://www.ncbi.nlm.nih.gov/pubmed/28060958
http://dx.doi.org/10.1371/journal.pone.0169673
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