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Genetics may be key to hormone therapy for bone fracture in women

Study shows postmenopausal women with the highest risk of bone fracture may get the most benefit from hormone therapy.

By Amy Wallace

April 24 (UPI) -- A new study by the University at Buffalo found women at the highest genetic risk of bone fracture benefit the most from hormone therapy.

Bone mineral density, or BMD, decreases as women age causing them to be at greater risk of fractures from falling. However, some women can have a genetic predisposition to fracture.

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The study of roughly 10,000 women from the national, long-term study Women's Health Initiative, of WHI, examined gene-hormone therapy on fracture in postmenopausal white women.

Researchers utilized the largest set of known genes associated with fracture risk from a meta-analysis of genome-wide studies.

"We found that women who are genetically at the highest risk can enjoy the greatest protection from fracture when they use hormone therapy," Heather Ochs-Balcom, an associate professor of epidemiology and environmental health at UB's School of Public Health and Health Professions, said in a press release. "This study provides a better understanding of who can benefit the most in terms of bone health from hormone therapy use. It's important information as women and their doctors make decisions about hormone therapy use."

Researchers created two weighted genetic risk scores based on 16 fracture-associated variants and 50 bone mineral density variants to assess the affect of hormone therapy on genetic risk of bone fracture.

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"Our study represents a first look at how inherited predisposition to fracture is related to hormone therapy use," Ochs-Balcom said. "This is important because, as previous WHI studies have identified, there are risks and benefits with hormone therapy. This is where precision or personalized medicine comes in -- the attempt to get the right drugs to the right person to ensure the most benefit and least harm."

Researchers found women taking hormone therapy were at a decreased risk of bone fracture, especially those women at highest genetic risk of fracture and low bone mineral density.

The study was published in The Journal of Clinical Endocrinology and Metabolism.

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