Retentissement osseux et cardio-vasculaire de l'hormonothérapie adjuvante du cancer du sein non métastatique

Cette étude prospective a pour objectif de déterminer l'impact de l'hormonothérapie du cancer du sein sur le tissu osseux et le système cardio-vasculaire, selon que les patientes aient bénéficié ou non d'une chimiothérapie adjuvante préalable et selon leur statut gonadique initial. 142 patientes ont été incluses dans cette étude : 77 ont été traitées par tamoxifène et 65 par un inhibiteur de l'aromatase, pendant une durée moyenne de 28 mois. Nos résultats montrent une perte osseuse plus marquée chez les patientes ayant reçu une chimiothérapie adjuvante, essentiellement du fait de la survenue d'une ménopause anticipée chimio-induite. Le tamoxifène ne permet pas de freiner la perte osseuse du début de la ménopause; par contre, chez les femmes initialement ménopausées, il est associé à une diminution significative du taux de perte osseuse contrairement à ce qui est observé chez les patientes traitées par un inhibiteur de l'aromatase. Au plan cardio-vasculaire, la chimiothérapie est responsable de modifications de la composition corporelle : augmentation du rapport masse grasse/masse maigre et redistribution androïde du tissu adipeux. Comme pour le tissu osseux, les effets de la chimiothérapie sont essentiellement la conséquence de son impact sur la fonction gonadique. Il ne semble pas y avoir un impact métabolique associé des traitements adjuvants du cancer du sein. En conclusion, notre étude souligne l'importance de l'évaluation du statut osseux initial des patientes traitées pour un cancer du sein ainsi que de l'impact des traitements adjuvants.TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications

Bone is a multi-skilled tissue, protecting major organs, regulating calcium phosphate balance and producing hormones. Its development during childhood determines height and stature as well as resistance against fracture in advanced age. Estrogens are key regulators of bone turnover in both females and males. These hormones play a major role in longitudinal and width growth throughout puberty as well as in the regulation of bone turnover. In women, estrogen deficiency is one of the major causes of postmenopausal osteoporosis. In this review, we will summarize the main clinical and experimental studies reporting the effects of estrogens not only in females but also in males, during different life stages. Effects of estrogens on bone involve either Estrogen Receptor (ER)α or ERβ depending on the type of bone (femur, vertebrae, tibia, mandible), the compartment (trabecular or cortical), cell types involved (osteoclasts, osteoblasts and osteocytes) and sex. Finally, we will discuss new ongoing strategies to increase the benefit/risk ratio of the hormonal treatment of menopause

Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications

Bone is a multi-skilled tissue, protecting major organs, regulating calcium phosphate balance and producing hormones. Its development during childhood determines height and stature as well as resistance against fracture in advanced age. Estrogens are key regulators of bone turnover in both females and males. These hormones play a major role in longitudinal and width growth throughout puberty as well as in the regulation of bone turnover. In women, estrogen deficiency is one of the major causes of postmenopausal osteoporosis. In this review, we will summarize the main clinical and experimental studies reporting the effects of estrogens not only in females but also in males, during different life stages. Effects of estrogens on bone involve either Estrogen Receptor (ER)α or ERβ depending on the type of bone (femur, vertebrae, tibia, mandible), the compartment (trabecular or cortical), cell types involved (osteoclasts, osteoblasts and osteocytes) and sex. Finally, we will discuss new ongoing strategies to increase the benefit/risk ratio of the hormonal treatment of menopause

EMAS position statement: managing obese postmenopausal women.

Obesity is a public health problem, with overweight individuals representing approximately 20% of the adult world population. Postmenopausal status is associated with higher prevalence of obesity, as 44% of postmenopausal women are overweight, among whom 23% are obese. Obesity often co-exists with other diseases, the most important being diabetes mellitus, dyslipidemia and hypertension. Furthermore, obesity increases the risk of gynecologic cancer, cardiovascular disease, venous thromboembolism, osteoarthritis and chronic back pain.Consensus Development ConferenceJournal Articleinfo:eu-repo/semantics/publishe

EMAS position statement: Managing the menopause in women with a past history of endometriosis

Introduction: Endometriosis is a common disease in women of reproductive age. The symptoms usually disappear after a natural or a surgical menopause. Estrogen-based hormone therapy is required in women with premature or early menopause until the average age of the natural menopause and should be considered in older women with severe climacteric symptoms. However use of hormone therapy raises concerns about disease recurrence with pain symptoms, need for surgery and possibly malignant transformation of residual endometriosis

EMAS position statement: Managing the menopause in the context of coronary heart disease.

Cardiovascular disease (CVD) including coronary heart disease (CHD) and stroke is the most common cause of female death. Premenopausal CHD is very rare but when women enter the menopause the incidence of CHD increases markedly. CHD presents 10 years later in women than in men. The reason is still unclear but the protective effects of estrogens have been suggested.Journal ArticlePractice Guidelineinfo:eu-repo/semantics/publishe

EMAS position statement: managing the menopause in women with epilepsy.

Epilepsy is a major public health problem worldwide which is clinically characterized by recurrent seizures.Consensus Development ConferenceJournal ArticleReviewinfo:eu-repo/semantics/publishe

Erratum to "EMAS position statement: Managing women with premature ovarian failure" (Maturitas (2010) 67, (91-93) DOI: 10.1016/j.maturitas. 2010.04.011)

SCOPUS: er.jinfo:eu-repo/semantics/publishe

EMAS clinical guide: selective estrogen receptor modulators for postmenopausal osteoporosis.

Osteoporosis and the resulting fractures are major public health issues as the world population is ageing. Various therapies such as bisphosphonates, strontium ranelate and more recently denosumab are available. This clinical guide provides the evidence for the clinical use of selective estrogen modulators (SERMs) in the management of osteoporosis in postmenopausal women.Journal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Erratum to "EMAS position statement: Managing obese postmenopausal women" (Maturitas (2010) 66, (323-326) DOI: 10.1016/j.maturitas.2010.03. 025)

SCOPUS: er.jinfo:eu-repo/semantics/publishe