Pluskiewicz W, Drozdzowska B, Straszak L
Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Silesian School of Medicine, Katowice, Poland.
Ultrasound Med Biol. 2003 Dec;29(12):1691-5. doi: 10.1016/j.ultrasmedbio.2003.08.017.
The aim of the observational study was to evaluate the influence of hormone replacement therapy (HRT) on the results of quantitative ultrasound (US) at the hand phalanges in 732 women (mean age about 53 years). Among them were 228 postmenopausal women treated within 6 months after the last menstrual bleeding (group 1), 90 postmenopausal women taking HRT after a break between menopause and the onset of the therapy of about 2 years (group 2) and 414 controls. Mean age and body size did not differ significantly between groups studied. Years since menopause (YSM) did not differ significantly between group 2 and controls. Skeletal status was assessed using DBM Sonic 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS) in m/s. Ad-SoS was significantly higher in both groups on HRT than in controls (p < 0.000001), and in group 1 compared with group 2 (p < 0.05). The duration of HRT did not affect Ad-SoS values. The influence of age on Ad-SoS values was significantly weaker in women on HRT than in controls and YSM did not influence Ad-SoS value in postmenopausal women taking HRT. In controls, YSM negatively and significantly affected Ad-SoS value. In conclusion, HRT administered in perimenopause or early postmenopause had a significant influence on quantitative US measurements at the hand phalanges, and the difference between both treated groups suggests that HRT ought to be indicated directly after the last menstrual bleeding.
这项观察性研究的目的是评估激素替代疗法(HRT)对732名女性(平均年龄约53岁)手部指骨定量超声(US)结果的影响。其中包括228名在最后一次月经出血后6个月内接受治疗的绝经后女性(第1组)、90名在绝经与开始治疗之间间隔约2年服用HRT的绝经后女性(第2组)以及414名对照者。各研究组之间的平均年龄和体型无显著差异。第2组和对照组之间的绝经年限(YSM)无显著差异。使用DBM Sonic 1200(意大利卡尔皮的IGEA公司)评估骨骼状态,该仪器测量以米/秒为单位的振幅依赖声速(Ad-SoS)。接受HRT的两组的Ad-SoS均显著高于对照组(p<0.000001),且第1组高于第2组(p<0.05)。HRT的持续时间不影响Ad-SoS值。接受HRT的女性中,年龄对Ad-SoS值的影响明显弱于对照组,且YSM对接受HRT的绝经后女性的Ad-SoS值无影响。在对照组中,YSM对Ad-SoS值有显著的负面影响。总之,围绝经期或绝经后早期给予HRT对手部指骨的定量超声测量有显著影响,两个治疗组之间的差异表明HRT应在最后一次月经出血后直接使用。