Department of Gynecology and Obstetrics, University of Naples Federico II, via S. Pansini 5, Naples, Italy.
Contraception. 2010 Mar;81(3):209-14. doi: 10.1016/j.contraception.2009.09.011. Epub 2009 Oct 29.
This study was conducted to compare the effects of the combined contraceptive vaginal ring releasing 15 mcg of ethinylestradiol (EE) and 120 mcg of etonorgestrel daily with the effects of the contraceptive patch, a transdermal system that delivers a daily dose of 20 mcg of EE and 150 mcg of norelgestromin on bone turnover and bone mineral density (BMD) in young fertile women.
On the basis of a randomized, computer-generated list, 40 women desiring contraception were assigned to a 12-month treatment with a patch delivering a daily dose of 20 mcg of EE and 150 mcg of norelgestromin (Evra, Janssen-Cilag, Italy) (Group A, n=20) or to a 12-month treatment with a vaginal ring releasing a daily dose of 15 mcg of EE and 120 mcg of etonorgestrel (NuvaRing, Organon, Italy) (Group B, n=20). Twenty patients underwent no treatment and were used as healthy controls (Group C, n=20). At 3, 6, 9 and 12 months, serum and urinary calcium, osteocalcin and urinary pyridinoline (PYD) and deoxypyridinoline (D-PYD) levels were measured. At baseline and after 12 months, lumbar BMD was determined by dual-energy X-ray absorptiometry.
In Groups A and B, urinary PYD and D-PYD at 6, 9 and 12 months were significantly reduced in comparison with basal values and Group C values (p<.05). In Groups A and B, serum calcium levels were significantly increased after 6 months. No significant difference was detected between Group A and Group B in urinary levels of PYD and D-PYD, in calcium levels and in osteocalcin levels. At 12 months, no significant difference was detected in spinal BMD values between the three groups and in comparison with basal values.
Both contraceptive systems exert a similar positive influence on bone turnover in young postadolescent women.
本研究旨在比较每日释放 15 微克炔雌醇（EE）和 120 微克依托孕烯的复方避孕阴道环与每日释放 20 微克 EE 和 150 微克去氧孕烯的避孕贴对年轻生育期妇女骨转换和骨密度（BMD）的影响。
根据随机、计算机生成的列表，40 名希望避孕的妇女被分配到为期 12 个月的治疗中，一组使用每日释放 20 微克 EE 和 150 微克去氧孕烯的贴剂（Evra，Janssen-Cilag，意大利）（A 组，n=20），另一组使用每日释放 15 微克 EE 和 120 微克依托孕烯的阴道环（NuvaRing，Organon，意大利）（B 组，n=20）。20 名患者未接受治疗，作为健康对照组（C 组，n=20）。在 3、6、9 和 12 个月时，测量血清和尿钙、骨钙素和尿吡啶啉（PYD）和脱氧吡啶啉（D-PYD）水平。在基线和 12 个月后，通过双能 X 射线吸收法测定腰椎 BMD。
在 A 组和 B 组中，6、9 和 12 个月时尿 PYD 和 D-PYD 与基础值和 C 组值相比显著降低（p<.05）。在 A 组和 B 组中，血清钙水平在 6 个月后显著升高。在 A 组和 B 组之间，PYD 和 D-PYD 的尿水平、钙水平和骨钙素水平无显著差异。在 12 个月时，三组间脊柱 BMD 值与基础值相比无显著差异。
两种避孕方法对年轻青春期后妇女的骨转换均有相似的积极影响。
