Grecu E O, Simmons R, Baylink D J, Haloran B P, Spencer M E
Department of Medicine (Endocrinology and Metabolism), Department of Veterans Affairs Medical Center, Martinez, CA.
Bone Miner. 1991 May;13(2):153-61. doi: 10.1016/0169-6009(91)90082-b.
Long-acting medroxyprogesterone acetate (MPA) effect on some important parameters of calcium metabolism in patients with glucocorticoid-induced osteoporosis (GCO) was evaluated. Twelve steroid-dependent asthmatic male patients with GCO were administered 200 mg of MPA (Depo-Provera) intramuscularly, and had fasting serum samples obtained at baseline and at weekly intervals for 5 consecutive weeks. Baseline serum samples were also obtained from 12 control healthy male subjects matched for age. The following measurements were made from each serum sample: osteocalcin (OC), skeletal (SAP) and total alkaline phosphatase (TAP), calcitonin (C), insulin-like growth factor I (IGF1), 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D. Significantly lower baseline serum levels of OC and C were found in the patients with GCO than in controls (P less than 0.001). Following MPA administration in GCO patients statistically significant and sustained increases in OC, SAP and C were noticed during the next 5 weeks. No significant differences in baseline levels for TAP, IGF1, 1,25(OH)2D and 25(OH)D between GCO patients and controls were found, and no significant changes following MPA administration in GCO patients were obtained for these parameters. In conclusion, when administered to patients with GCO, MPA seems to stimulate the osteoblastic activity as suggested by sustained increases in OC and SAP serum levels, and also enhances the C production by the C-cells of the thyroid.
评估了长效醋酸甲羟孕酮（MPA）对糖皮质激素诱导的骨质疏松症（GCO）患者钙代谢一些重要参数的影响。对12名患有GCO的依赖类固醇的男性哮喘患者肌肉注射200mg MPA（醋酸甲羟孕酮避孕针），并在基线时以及连续5周每周采集空腹血清样本。还从12名年龄匹配的健康男性对照受试者中采集了基线血清样本。对每个血清样本进行了以下测量：骨钙素（OC）、骨特异性（SAP）和总碱性磷酸酶（TAP）、降钙素（C）、胰岛素样生长因子I（IGF1）、1,25 - 二羟维生素D和25 - 羟维生素D。发现GCO患者的OC和C基线血清水平显著低于对照组（P小于0.001）。在GCO患者中给予MPA后，在接下来的5周内注意到OC、SAP和C有统计学意义的持续升高。GCO患者与对照组之间TAP、IGF1、1,25(OH)2D和25(OH)D的基线水平没有显著差异，并且GCO患者给予MPA后这些参数没有显著变化。总之，当给GCO患者使用时，MPA似乎如OC和SAP血清水平的持续升高所表明的那样刺激成骨细胞活性，并且还增强甲状腺C细胞的C分泌。
