Holland E F, Studd J W, Mansell J P, Leather A T, Bailey A J
Department of Gynaecology, Chelsea and Westminster Hospital, London, United Kingdom.
Obstet Gynecol. 1994 Feb;83(2):180-3.
To determine the effects of percutaneous estradiol (E2) implants on the collagen composition and maturity in the bone and skin of osteoporotic postmenopausal women.
Sixteen postmenopausal women with low bone mineral density were treated for 1 year with 75-mg E2 implants. Iliac crest bone and skin biopsies were analyzed for collagen content and collagen cross-links before treatment and at 1 year. Dual energy x-ray absorptiometry of the lumbar spine and proximal femur was also performed before and after 1 year of therapy.
The cortical bone showed a significant increase in the mature cross-links of both hydroxylysylpyridinoline (P < .01) and lysylpyridinoline (P < .01), with a significant reduction in the percentage of collagen (P < .001). The pattern was similar in trabecular bone, with lysylpyridinoline increasing significantly (P < .05). The skin exhibited a significant reduction in the immature cross-link hydroxylysinonorleucine (P < .01), but no significant change in the percentage of collagen content or the mature cross-link histidinohydroxylysinonorleucine. The median increases in bone density were 11.5% at the spine and 4.34% at the total hip. The median post-treatment serum E2 level was 639 pmol/L.
Bone mineral density increased at all the sites measured in the spine and proximal hip. The quality of the collagen within the transiliac biopsies had matured in that the concentration of the mature collagen cross-links had increased. These findings support a reduction in the turnover of bone collagen following estrogen replacement therapy. More important, the formation of a more mature collagen fiber should help to reduce the risk of future bone fracture.
确定经皮雌二醇（E2）植入物对绝经后骨质疏松女性骨骼和皮肤中胶原蛋白组成及成熟度的影响。
16名骨矿物质密度低的绝经后女性接受75毫克E2植入物治疗1年。在治疗前及治疗1年后，对髂嵴骨和皮肤活检组织进行胶原蛋白含量及胶原蛋白交联分析。同时在治疗1年前后对腰椎和股骨近端进行双能X线吸收测定。
皮质骨中羟赖氨酰吡啶啉（P <.01）和赖氨酰吡啶啉（P <.01）的成熟交联均显著增加，胶原蛋白百分比显著降低（P <.001）。小梁骨的情况类似，赖氨酰吡啶啉显著增加（P <.05）。皮肤中未成熟交联羟赖氨酸正亮氨酸显著减少（P <.01），但胶原蛋白含量百分比及成熟交联组氨酸羟赖氨酸正亮氨酸无显著变化。脊柱骨密度中位数增加11.5%，全髋骨密度中位数增加4.34%。治疗后血清E2水平中位数为639 pmol/L。
在测量的脊柱和近端髋部所有部位，骨矿物质密度均增加。经髂骨活检组织中胶原蛋白质量已成熟，成熟胶原蛋白交联浓度增加。这些发现支持雌激素替代治疗后骨胶原蛋白周转率降低。更重要的是，形成更成熟的胶原纤维应有助于降低未来骨折风险。
