Thomsen K, Riis B J, Johansen J S, Christiansen C, Rødbro P
Department of Clinical Chemistry, University of Copenhagen, Glostrup Hospital, Denmark.
Gynecol Endocrinol. 1987 Jun;1(2):169-75. doi: 10.3109/09513598709030680.
Bone turnover before and after withdrawal of estrogen/gestagen treatment was studied in a randomized trial with 110 healthy female volunteers, who had passed a natural menopause 6 months to 3 years before the start of the study. Urinary excretion of intravenously injected 99m-technetium diphosphonate was measured as an index of bone turnover; plasma bone Gla protein and serum alkaline phosphatase were measured as indices of bone formation; and fasting urinary excretion of hydroxyproline and calcium were measured as estimates of bone resorption. During 2 years of hormone treatment, all variables decreased highly significantly (p less than 0.001) to a constant low level. Three months after withdrawal all variables increased highly significantly (p less than 0.001) towards, but not above, pretreatment and placebo levels. We conclude that withdrawal of estrogen/gestagen replacement therapy in postmenopausal women increases bone turnover, but not in excess of pretreatment values. This indicates that bone loss (after withdrawal) is similar to that seen in the placebo group and that a rebound phenomenon is unlikely.
在一项随机试验中，对110名健康女性志愿者进行了研究，观察雌激素/孕激素治疗停药前后的骨转换情况。这些志愿者在研究开始前6个月至3年经历了自然绝经。静脉注射99m-锝二膦酸盐后的尿排泄量作为骨转换指标进行测量；血浆骨钙素和血清碱性磷酸酶作为骨形成指标进行测量；空腹尿中羟脯氨酸和钙的排泄量作为骨吸收的估计值进行测量。在2年的激素治疗期间，所有变量均高度显著下降（p<0.001）至恒定的低水平。停药3个月后，所有变量均高度显著升高（p<0.001），接近但未超过治疗前和安慰剂水平。我们得出结论，绝经后女性停用雌激素/孕激素替代疗法会增加骨转换，但不会超过治疗前的值。这表明（停药后）骨质流失与安慰剂组相似，不太可能出现反跳现象。
