Family Planning Clinic, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
Division of Endocrinology, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
Int J Gynaecol Obstet. 2019 Dec;147(3):319-325. doi: 10.1002/ijgo.12958. Epub 2019 Sep 20.
To evaluate calcium metabolism and bone mineral density (BMD) in new users of depot medroxyprogesterone acetate (DMPA) in the first year of use.
This prospective, non-randomized study, conducted at the University of Campinas, São Paulo, Brazil, was carried out between February 2011 and February 2013. Women aged from 18 to 40 with a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) <30 and with no known history of disease or medication use who chose to use DMPA were paired by age (±1 year) and BMI (±1) with women commencing the use of a copper intrauterine device (IUD). The primary outcomes were BMD measured by dual-energy X-ray absorptiometry and calcium metabolism markers; other variables were body composition and lifestyle habits. Repeated measures analysis of variance (ANOVA) and multiple regression analyses were used to evaluate associations.
Twenty-seven women using DMPA and 24 using IUD were evaluated, with a mean age of 29.7 years and 28.6 years, respectively. The DMPA group presented with a 3.6% (P<0.001) loss of lumbar spine BMD, a 2.1% (P=0.100) loss of femoral neck BMD and higher phosphorus (P=0.014) concentrations at 12 months compared to the IUD group. The decreases in BMD were associated with the use of DMPA, while total mass and coffee intake were found to be protective factors.
Changes in calcium metabolism and a decrease in BMD were found in the DMPA group at 12 months.
评估新使用长效醋酸甲羟孕酮（DMPA）的患者在使用后的第一年的钙代谢和骨密度（BMD）。
这是一项在巴西坎皮纳斯大学进行的前瞻性、非随机研究，于 2011 年 2 月至 2013 年 2 月进行。选择使用 DMPA 的年龄在 18 至 40 岁之间、体重指数（BMI，计算为体重除以身高的平方）<30 且无已知疾病或用药史的女性，按照年龄（±1 岁）和 BMI（±1）与开始使用铜宫内节育器（IUD）的女性进行配对。主要结局为双能 X 线吸收法测量的 BMD 和钙代谢标志物；其他变量为身体成分和生活方式习惯。采用重复测量方差分析（ANOVA）和多元回归分析来评估相关性。
共评估了 27 名使用 DMPA 和 24 名使用 IUD 的女性，平均年龄分别为 29.7 岁和 28.6 岁。与 IUD 组相比，DMPA 组在 12 个月时腰椎 BMD 降低了 3.6%（P<0.001），股骨颈 BMD 降低了 2.1%（P=0.100），且磷浓度更高（P=0.014）。BMD 的降低与 DMPA 的使用有关，而总体质量和咖啡摄入量被认为是保护因素。
在 12 个月时，DMPA 组的钙代谢发生变化，BMD 降低。
