Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Endocrinol (Lausanne). 2021 Mar 11;12:649952. doi: 10.3389/fendo.2021.649952. eCollection 2021.
Hip structural analysis (HSA) is a method for evaluating bone geometry reflecting bone structural and biomechanical properties. However, tissue-selective estrogen complex (TSEC) treatment effects on HSA have not been investigated.
This study was performed to evaluate the effect of TSEC treatment on hip geometry in postmenopausal Korean women. The treatment was given for 12 months, and hip geometry was measured by HSA.
A total of 40 postmenopausal women who received TSEC containing conjugated estrogen 0.45 mg and bazedoxifene 20 mg for treating vasomotor symptoms were included in this retrospective cohort study. The changes in bone mineral density and parameters of HSA including the outer diameter, cross-sectional area, cross-sectional moment of inertia, cortical thickness, section modulus, and buckling ratio as determined by dual-energy X-ray absorptiometry were compared before and after 12 months of TSEC treatment.
Mean age and years since menopause were 55.1 and 4.5 years, respectively. Total hip bone mineral density significantly increased by 0.74% after treatment (P=0.011). The changes in HSA were mainly demonstrated in the narrow femoral neck: cross-sectional area (P=0.003) and cortical thickness (P<0.001) increased significantly. For the shaft region, only SM decreased significantly after treatment (P=0.009). However, most parameters did not change significantly with TSEC treatment in the intertrochanteric and shaft regions.
Our findings demonstrate that 12 months of TSEC treatment could improve bone geometry as measured by HSA. The findings suggest that TSEC might be an interesting option for the prevention of fracture as well as osteoporosis in postmenopausal women.
髋关节结构分析（HSA）是一种评估反映骨骼结构和生物力学特性的骨几何形状的方法。然而，尚未研究组织选择性雌激素复合物（TSEC）治疗对 HSA 的影响。
本研究旨在评估 TSEC 治疗对绝经后韩国女性髋部几何形状的影响。治疗持续 12 个月，并通过 HSA 测量髋部几何形状。
本回顾性队列研究共纳入 40 名接受 TSEC 治疗的绝经后妇女，该治疗方案包含结合雌激素 0.45mg 和巴多昔芬 20mg，用于治疗血管舒缩症状。比较了 12 个月 TSEC 治疗前后骨密度和 HSA 参数（外径、横截面积、截面惯性矩、皮质厚度、截面模数和屈曲比）的变化，这些参数通过双能 X 线吸收法确定。
平均年龄和绝经年限分别为 55.1 岁和 4.5 年。治疗后全髋骨密度显著增加 0.74%（P=0.011）。HSA 的变化主要表现在狭窄的股骨颈：横截面积（P=0.003）和皮质厚度（P<0.001）显著增加。对于骨干区域，只有 SM 在治疗后显著降低（P=0.009）。然而，在转子间和骨干区域，大多数参数在 TSEC 治疗后没有显著变化。
我们的研究结果表明，12 个月的 TSEC 治疗可以改善 HSA 测量的骨几何形状。这些发现表明，TSEC 可能是绝经后妇女预防骨折和骨质疏松的一种有趣选择。
