Shiraki M, Orimo H
Department of Laboratory Medicine, Tokyo Metropolitan Geriatric Hospital.
Nihon Naibunpi Gakkai Zasshi. 1991 Feb 20;67(2):84-95. doi: 10.1507/endocrine1927.67.2_84.
In order to assess the effect of sex steroids on bone mineral density in Japanese with senile osteoporosis, the bone mineral density in 1/3 distal site of radius was measured serially before and after treatment for 2 years using single photon absorptiometry. Sixty seven old females with senile osteoporosis were divided into 4 groups, Group 1 (n = 28, mean age; 74.4 +/- 1.3 y.o., mean +/- SEM) was the control group, Group 2 (n = 14, mean age; 73.7 +/- 1.7 y.o.) was treated with 0.5-1.0 micrograms/day of 1 alpha -OHD3, Group 3 (n = 12, mean age; 75.4 +/- 2.9 y.o.) was treated with conjugated estrogen (Premarin) in a dose of 0.3125 mg/day (3 approximately 4 weeks administration followed by 1 week rest) and Group 4 (n = 13, mean age; 76.4 +/- 1.8 y.o.) was treated with sex-steroids (pregnenolone : androstenedione : androstenediol : testosterone : estrone = 1.0 mg : 1.0 mg : 0.5 mg : 0.1 mg : 5 micrograms/tablet) and thyroid hormone (thyroid-sicca 7.5 mg/tablet) preparation in a dose of 2 tablets/day. When the radial bone mineral density (RMD) before the treatment was taken as 100%, RMDs of each group at 6, 12, 18 and 24 months were 96.4 +/- 3.1%, 97.3 +/- 2.0%, 93.7 +/- 2.1% and 96.1 +/- 1.8% in Group 1, 100.8 +/- 2.8%, 106.4 +/- 2.1%, 101.3 +/- 3.4% and 108.8 +/- 2.9% in Group 2, 103.0 +/- 2.8%, 106.2 +/- 3.5%, 105.9 +/- 4.3% and 100.2 +/- 4.7% in Group 3, 105.3 +/- 2.2%, 104.7 +/- 2.3%, 112.6 +/- 6.4% and 112.1 +/- 6.7% in Group 4, respectively. Therefore, significant increases in RMD were observed in Groups 2, 3 (transient) and 4 when compared with Group 1. In Group 3, serum level of parathyroid hormone (PTH) was significantly (p less than 0.05) increased from 0.28 +/- 0.03 ng/ml before the treatment to 0.55 +/- 0.15 ng/ml at 24 months after the treatment. In Group 2, transient (6 months after the treatment) but significant (p less than 0.01) increase in urinary Ca/Creatinine ratio from 0.15 +/- 0.04 to 0.20 +/- 0.03 was found. Serum A1-P activities in Group 4 was shown to increase transiently from 131 +/- 10 IU to 151 +/- 12 IU (p less than 0.05) at 6 months and to 158 +/- 13 IU (p less than 0.01) at 12 months followed by subsequent decrease to 135 +/- 6 IU at 18 months and 133 +/- 10 IU at 24 months after the treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
为评估性类固醇对日本老年骨质疏松症患者骨矿物质密度的影响,采用单光子吸收法对67例老年女性骨质疏松症患者治疗前及治疗2年期间桡骨远端1/3处的骨矿物质密度进行了连续测量。67例老年女性骨质疏松症患者被分为4组,第1组(n = 28,平均年龄:74.4±1.3岁,平均值±标准误)为对照组,第2组(n = 14,平均年龄:73.7±1.7岁)接受每日0.5 - 1.0微克的1α-羟化维生素D3治疗,第3组(n = 12,平均年龄:75.4±2.9岁)接受剂量为0.3125毫克/天的结合雌激素(普雷马林)治疗(给药3至4周后休息1周),第4组(n = 13,平均年龄:76.4±1.8岁)接受性类固醇(孕烯醇酮:雄烯二酮:雄烯二醇:睾酮:雌酮 = 1.0毫克:1.0毫克:0.5毫克:0.1毫克:5微克/片)和甲状腺激素(甲状腺干制剂7.5毫克/片)治疗,剂量为每日2片。以治疗前的桡骨骨矿物质密度(RMD)为100%,第1组在6、12、18和24个月时的RMD分别为96.4±3.1%、97.3±2.0%、93.7±2.1%和96.1±1.8%,第2组分别为100.8±2.8%、106.4±2.1%、101.3±3.4%和108.8±2.9%,第3组分别为103.0±2.8%、106.2±3.5%、105.9±4.3%和100.2±4.7%,第4组分别为105.·3±2.2%、104.7±2.3%、112.6±6.4%和112.1±6.7%。因此,与第1组相比,第2、3组(短暂性)和第4组的RMD显著增加。在第3组中,甲状旁腺激素(PTH)血清水平从治疗前的0.28±0.03纳克/毫升显著(p<0.05)升高至治疗24个月后的0.55±0.15纳克/毫升。在第2组中,尿钙/肌酐比值从0.15±0.04短暂性(治疗6个月后)但显著(p<0.01)升高至0.20±0.03。第4组血清碱性磷酸酶(A1-P)活性在治疗6个月时从131±10国际单位短暂性升高至151±12国际单位(p<0.05),在12个月时升高至158±13国际单位(p<0.01),随后在治疗18个月时降至135±6国际单位,在24个月时降至133±10国际单位。(摘要截短于400字)