Lewis L L, Shaver J F, Woods N F, Lentz M J, Cain K C, Hertig V, Heidergott S
Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle 98195, USA.
Menopause. 2000 Jan-Feb;7(1):42-52. doi: 10.1097/00042192-200007010-00008.
The purpose of this study was to describe bone resorption activity using a biochemical marker according to the categories of age, menopausal status, and selected drug/supplement use in middle-aged and elderly community-based women.
This was a cross-sectional study that assessed urinary cross-linked N-telopeptide of type I collagen (NTx) and used self-report data to group women as premenopausal (Pre), perimenopausal (Peri), postmenopausal without hormone replacement therapy (Post), and postmenopausal with hormone replacement therapy (HRT).
Mean NTx values were found to be significantly different by group and controlling for age (p = 0.001), with post hoc tests showing all pairwise group comparisons as significantly different (p = 0.001), except that the Pre and HRT groups were not significantly different. Both the Peri and the Post NTx levels were significantly higher than the Pre and the HRT groups'. NTx values in the Peri group varied with age-the youngest Peri women were similar to Pre women, and the oldest Peri women were similar to Post women. Significantly lower NTx levels were found only in the Post (p = 0.009) and HRT (p < 0.001) groups using diuretics compared with nonuse and only in the HRT group using calcium supplements compared with nonuse (p = 0.006). No differences by thyroid use were found. With a biochemical marker, the results showed that bone resorption activity differences could be demarcated in women according to age, estimated menopausal stage, and selected drug/supplement use.
These results support the usefulness of NTx assessment for indicating bone resorption activity and therefore the potential for osteoporosis or for monitoring the efficacy of antiresorptive therapies.
本研究旨在根据年龄、绝经状态以及中年和老年社区女性使用特定药物/补充剂的情况,利用生化标志物描述骨吸收活性。
这是一项横断面研究,评估了尿I型胶原交联N-末端肽(NTx),并使用自我报告数据将女性分为绝经前(Pre)、围绝经期(Peri)、未接受激素替代疗法的绝经后(Post)以及接受激素替代疗法的绝经后(HRT)组。
发现各组的平均NTx值在控制年龄后存在显著差异(p = 0.001),事后检验显示除Pre组和HRT组无显著差异外,所有两两分组比较均有显著差异(p = 0.001)。Peri组和Post组的NTx水平均显著高于Pre组和HRT组。Peri组的NTx值随年龄变化——最年轻的Peri组女性与Pre组女性相似,最年长的Peri组女性与Post组女性相似。与未使用利尿剂相比,仅Post组(p = 0.009)和HRT组(p < 0.001)使用利尿剂时NTx水平显著降低;与未使用钙补充剂相比,仅HRT组使用钙补充剂时NTx水平显著降低(p = 0.006)。未发现甲状腺药物使用情况存在差异。结果表明,利用生化标志物可根据年龄、估计的绝经阶段以及特定药物/补充剂的使用情况区分女性的骨吸收活性差异。
这些结果支持NTx评估在指示骨吸收活性方面的有用性,因此在骨质疏松症诊断或抗吸收治疗疗效监测方面具有潜在应用价值。