激素替代疗法对骨量及吡啶交联物尿排泄的影响。

Effect of hormone replacement therapy on the bone mass and urinary excretion of pyridinium cross-links.

作者信息

Pardini D P, Sabino A T, Meneses A M, Kasamatsu T, Vieira J G

机构信息

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2000 Jan 6;118(1):3-6. doi: 10.1590/s1516-31802000000100002.

DOI:10.1590/s1516-31802000000100002

PMID:10685120

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11166244/

Abstract

CONTEXT

The menopause accelerates bone loss and is associated with an increased bone turnover. Bone formation may be evaluated by several biochemical markers. However, the establishment of an accurate marker for bone resorption has been more difficult to achieve.

OBJECTIVE

To study the effect of hormone replacement therapy (HRT) on bone mass and on the markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline.

DESIGN

Cohort correlational study.

SETTING

Academic referral center.

SAMPLE

53 post-menopausal women, aged 48-58 years.

MAIN MEASUREMENTS

Urinary pyr and d-pyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography and corrected for creatinine excretion measured before treatment and after 1, 2, 4 and 12 months. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DEXA) before treatment and after 12 months of HRT.

RESULTS

The BMD after HRT was about 4.7% (P < 0.0004); 2% (P < 0.002); and 3% (P < 0. 01) higher than the basal values in lumbar spine, neck and trochanter respectively. There were no significant correlations between pyridinium cross-links and age, weight, menopause duration and BMD. The decrease in pyr and d-pyr was progressive after HRT, reaching 28.9% (P < 0.0002), and 42% (P < 0.0002) respectively after 1 year.

CONCLUSIONS

Urinary pyridinoline and deoxypyridinoline excretion decreases early in hormone replacement therapy, reflecting a decrease in the bone resorption rate, and no correlation was observed with the bone mass evaluated by densitometry.

摘要

背景

绝经会加速骨质流失，并与骨转换增加有关。骨形成可通过多种生化标志物进行评估。然而，建立一种准确的骨吸收标志物则更具难度。

目的

研究激素替代疗法（HRT）对骨量及骨吸收标志物——吡啶啉和脱氧吡啶啉尿排泄量的影响。

设计

队列相关性研究。

地点

学术转诊中心。

样本

53名48 - 58岁的绝经后女性。

主要测量指标

采用高效液相色谱后荧光分光光度法测定空腹尿样中的尿吡啶啉（pyr）和脱氧吡啶啉（d - pyr），并根据治疗前及治疗1、2、4和12个月后测得的肌酐排泄量进行校正。采用双能X线吸收法（DEXA）在治疗前及HRT治疗12个月后测量骨密度（BMD）。

结果

HRT治疗后，腰椎、颈部和转子处的骨密度分别比基础值高约4.7%（P < 0.0004）、2%（P < 0.002）和3%（P < 0.01）。吡啶交联物与年龄、体重、绝经持续时间和骨密度之间无显著相关性。HRT治疗后，pyr和d - pyr逐渐下降，1年后分别降至28.9%（P < 0.0002）和42%（P < 0.0002）。