Voetberg G A, Netelenbos J C, Kenemans P, Peters-Muller E R, van de Weijer P H
Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 1994 Nov;79(5):1465-9. doi: 10.1210/jcem.79.5.7962344.
Lipid and bone metabolism was studied in 165 healthy postmenopausal women treated with 2 mg 17 beta-estradiol continuously combined with one of four doses (2.5, 5, 10, or 15 mg) of dydrogesterone in a double blind randomized study design. Fasting blood and urine samples were drawn at baseline and after 3 and 6 months of treatment. Bone remodeling was significantly reduced in all four treatment groups, as indicated by the decrease in serum corrected calcium, phosphate, and alkaline phosphatase and the urinary calcium/creatinine ratio. A dose response of dydrogesterone on these indices was not found. With all four dosages of dydrogesterone, lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and apolipoproteins) improved significantly; however, this was less pronounced with the highest dydrogesterone dose. Our data suggest that continuously applied dydrogesterone in combined hormone replacement therapy does not annihilate the beneficial effects on bone remodeling and lipid metabolism induced by estrogens.
在一项双盲随机研究设计中，对165名健康绝经后女性进行了脂质和骨代谢研究，这些女性连续接受2毫克17β-雌二醇治疗，并联合四种剂量（2.5毫克、5毫克、10毫克或15毫克）之一的地屈孕酮。在基线以及治疗3个月和6个月后采集空腹血液和尿液样本。所有四个治疗组的骨重塑均显著降低，血清校正钙、磷酸盐和碱性磷酸酶以及尿钙/肌酐比值下降表明了这一点。未发现地屈孕酮对这些指标有剂量反应。使用所有四种剂量的地屈孕酮时，血脂谱（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和载脂蛋白）均显著改善；然而，地屈孕酮最高剂量时这种改善不太明显。我们的数据表明，在联合激素替代疗法中持续应用地屈孕酮不会消除雌激素对骨重塑和脂质代谢的有益作用。
