Ortiz Núñez Dámaris Alejandra, Mengchún López Gabriel, Hernández Marín Imelda, Mendoza Rosario, Ayala Ruíz Aquiles R
Departamento de medicina de la reproducción humana, dirección de investigación y enseñanza, Hospital Juárez de México, SSA, DF.
Ginecol Obstet Mex. 2004 Jul;72:349-55.
Several studies suggest that hormone replacement therapy (HRT) stops bone loss in postmenopausal women while increasing their bone mineral density up to 20%; however, there are studies where hormone replacement therapy does not increase bone density, only prevents it.
To analyze the effect of hormone replacement therapy upon bone mineral density of hip and lumbar spine in postmenopausal women.
Clinical files of several patients with sudden menopause diagnosis seen at the Hospital Juarez of Mexico were reviewed in the year 2000. They received hormone replacement therapy of conjugated estrogens and medroxyprogesterone acetate, with annual controls of estradiol in blood, equal or higher than 50 pg/mL and bone mineral density measurement (BMD) with DEXA (dual energy X-ray absortiometry) central (hip and lumbar spine), and at least one control within a period of four years. 89 patients were included and four groups were determined: all of them had basal densitometry in one (group 1), two (group 2), three (group 3), and four years (group 4) of monitoring. The percentage of bone mineral density was calculated in both anatomic areas and per group. In each study group the number or patients that showed gain, loss or whose mineral bone density stayed the same was assessed. The statistical analysis was made using the Student t test.
The 89 patients mean age was of 50.5 (SD +/- 6.42) years. All of them showed spontaneous menopause. The average time of menopause evolution was of 6.9 (SD +/- 4.7) years. The body mass index (BMI) average was of 27.5 (SD +/- 3.97) kg/m2. After admittance, all patients received hormone replacement therapy with conjugated equine estrogens (0.625 mg and medroxyprogesterone acetate 2.5 mg/day). A gain of bone mineral density in the second and third year of treatment in the left hip and in the lumbar spine was observed; however, there were no important differences in any study group when results were treated statistically.
Hormone replacement therapy was not effective to prevent bone loss, neither to increase bone density. Only one treatment was tested, and might be necessary to investigate the effect of other routes of administration or formulations.
多项研究表明，激素替代疗法（HRT）可阻止绝经后女性的骨质流失，同时将其骨矿物质密度提高20%；然而，也有研究表明激素替代疗法并不会增加骨密度，只是防止其降低。
分析激素替代疗法对绝经后女性髋部和腰椎骨矿物质密度的影响。
回顾了2000年在墨西哥华雷斯医院确诊为突然绝经的数名患者的临床档案。她们接受了结合雌激素和醋酸甲羟孕酮的激素替代疗法，每年检测血液中的雌二醇水平，使其等于或高于50 pg/mL，并使用双能X线吸收法（DEXA）对髋部和腰椎进行骨矿物质密度（BMD）测量，且在四年内至少进行一次检测。共纳入89名患者，并分为四组：所有患者在监测的一年（第1组）、两年（第2组）、三年（第3组）和四年（第4组）时均进行了基础骨密度测定。计算两个解剖部位以及每组的骨矿物质密度百分比。评估每个研究组中骨密度增加、降低或保持不变的患者数量。采用Student t检验进行统计分析。
89名患者的平均年龄为50.5（标准差±6.42）岁。她们均为自然绝经。绝经的平均时间为6.9（标准差±4.7）年。体重指数（BMI）的平均值为27.5（标准差±3.97）kg/m²。入院后，所有患者均接受了结合马雌激素（0.625 mg）和醋酸甲羟孕酮（2.5 mg/天）的激素替代疗法。在治疗的第二年和第三年，观察到左髋部和腰椎的骨矿物质密度有所增加；然而，在对结果进行统计学处理时，任何研究组之间均无显著差异。
激素替代疗法在预防骨质流失和增加骨密度方面均无效。仅测试了一种治疗方法，可能有必要研究其他给药途径或制剂的效果。
