 |
|
Opioid Osteoporosis—Reply
|
|
| Since this article does not have an abstract, we have provided the first 146 words of the full text and any section headings. |
|
|
|
In reply
As pointed out by Dr Daniell, the increased risk of fractures in older women taking narcotics in our study may, in part, be due to the effects of narcotics on production of endogenous sex steroids, including testosterone and estradiol, and bone turnover. We acknowledge his previous cross-sectional study1 that found lower levels of free testosterone and estradiol in a group of community-dwelling men taking sustained-action oral opioids for nonmalignant pain compared with a sex-matched control group. These effects may lead to lower bone density and decreased muscle strength, though neither low bone density nor impaired neuromuscular function in the older women taking narcotics in our study entirely explained their increased risk of fractures. Prospective studies of the associations between opioid use and changes in sex steroids, markers of bone turnover, and rates of bone loss are needed to demonstrate the causality of these relationships.
Kristine E. Ensrud, MD, MPH
Minneapolis, Minn
1. Daniell HW. Hypogonadism in men consuming sustained-action oral opioids. J Pain. 2002;3:377-384.
FULL TEXT
|
ISI
| PUBMED
Arch Intern Med. 2004;164:338.
RELATED ARTICLES
Opioid Osteoporosis
Harry W. Daniell
Arch Intern Med. 2004;164(3):338.
EXTRACT
| FULL TEXT
Central Nervous System Active Medications and Risk for Fractures in Older Women
Kristine E. Ensrud, Terri Blackwell, Carol M. Mangione, Paula J. Bowman, Douglas C. Bauer, Ann Schwartz, Joseph T. Hanlon, Michael C. Nevitt, and Mary A. Whooley
Arch Intern Med. 2003;163(8):949-957.
ABSTRACT
| FULL TEXT
|
