University of Lincoln, Lincoln LN6 7TS, UK; Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham NG11 8NS, UK.
Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham NG11 8NS, UK.
Bone. 2021 Apr;145:115864. doi: 10.1016/j.bone.2021.115864. Epub 2021 Jan 26.
There is a need to further understand the impact of the menstrual cycle and phase of combined oral contraceptive (COC) use on the pre-analytical variability of markers of bone metabolism in order to improve standardisation procedures for clinical practice and research. The aim of this study was to assess bone metabolism marker concentrations across the menstrual cycle and phases of COC use. Carboxy-terminal cross-linking telopeptide of type I collagen (β-CTX), procollagen type 1 N propeptide (P1NP) and Bone alkaline phosphatase (Bone ALP) concentrations were assessed in eumenorrheic women (n = 14) during the early follicular, ovulatory and mid-luteal phases of the menstrual cycle and in COC (Microgynon®) (n = 14) users on day 2-3 of pill consumption (PC1), day 15-16 pill consumption (PC2) and day 3-4 of the pill free interval (PFI). β-CTX was significantly (-16%) lower at PC2 compared to PC1 (P = 0.015) in COC users and was not affected by menstrual cycle phase (P > 0.05). P1NP and Bone ALP were not significantly different across either menstrual cycle phase or phase of COC use (all P > 0.05). There was no difference in pooled bone marker concentrations between eumenorrheic women and COC users (P > 0.05). In contrast to some previous studies, this study showed that bone marker concentrations do not significantly fluctuate across the menstrual cycle. Furthermore, bone resorption markers are significantly affected by phase of COC use, although bone formation markers do not significantly vary by COC phase. Therefore, the phase of COC use should be considered in clinical practice and research when assessing markers of bone metabolism as this can impact circulating concentrations of bone metabolic markers yet is not currently considered in existing guidelines for best practice.
需要进一步了解月经周期和复方口服避孕药（COC）使用阶段对骨代谢标志物分析前变异性的影响，以便改善临床实践和研究的标准化程序。本研究旨在评估整个月经周期和 COC 使用阶段骨代谢标志物浓度。在月经周期的早期卵泡期、排卵期和中期黄体期，评估了 14 名月经规律的女性（n=14）和 14 名 COC（Microgynon®）使用者（在药丸服用的第 2-3 天（PC1）、第 15-16 天（PC2）和药丸停药期的第 3-4 天（PFI））的Ⅰ型胶原羧基末端交联肽（β-CTX）、Ⅰ型前胶原 N 端前肽（P1NP）和骨碱性磷酸酶（Bone ALP）浓度。与 PC1 相比，COC 使用者在 PC2 时β-CTX 显著降低（-16%）（P=0.015），且不受月经周期阶段的影响（P>0.05）。P1NP 和 Bone ALP 在月经周期阶段或 COC 使用阶段均无显著差异（所有 P>0.05）。月经规律的女性和 COC 使用者的骨标志物浓度无差异（P>0.05）。与之前的一些研究不同，本研究表明骨标志物浓度在整个月经周期内没有明显波动。此外，骨吸收标志物受 COC 使用阶段的显著影响，而骨形成标志物不受 COC 阶段的显著影响。因此，在评估骨代谢标志物时，应考虑 COC 使用阶段，因为这会影响骨代谢标志物的循环浓度，但目前在最佳实践的现有指南中并未考虑这一点。
