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雌激素替代疗法是否会影响绝经后女性甲状旁腺激素对外源性高钙血症的反应?

Does estrogen replacement therapy influence parathyroid hormone responsiveness to exogenous hypercalcemia in postmenopausal women?

作者信息

Zofková I, Röjdmark S, Kancheva R L

机构信息

Institute of Endocrinology, Prague, Czech Republic.

出版信息

J Endocrinol Invest. 1993 May;16(5):323-7. doi: 10.1007/BF03348845.

Abstract

In postmenopausal women PTH suppression by exogenous calcium is reduced. To test whether this finding might be caused by estrogen deficiency 9 postmenopausal women were given transdermal estradiol (E2) treatment for 3 months at a dose of 100 micrograms/day. PTH reactivity to iv administration of CaCl2 was determined before and at the end of the E2-treatment period. Compliance to treatment was checked by determination of serum levels of E2 and FSH. The E2 level rose from 0.1 +/- 0.02 (mean +/- SE) to 0.46 +/- 0.10 mmol/l p < 0.01), whereas the corresponding FSH level declined from 77.5 +/- 7.4 to 33.9 +/- 5.7 U/l p < 0.01). This suggests good compliance. At the end of E2-treatment period calcium administration induced a higher PTH suppression as compared with control value (the PTH decremental area 2123 +/- 270 vs 1253 +/- 253 ng/l x min, p < 0.05), although a lower calcemic response was attained (the Ca incremental area 32.6 +/- 6.1 vs 47.4 +/- 4.5 mmol/ml x min, p < 0.05). These results imply that parathyroid glands are dependent on an adequate estrogen provision to respond normally to serum calcium changes.

摘要

绝经后女性对外源性钙的甲状旁腺激素(PTH)抑制作用减弱。为了检验这一发现是否可能由雌激素缺乏引起,9名绝经后女性接受了为期3个月的经皮雌二醇(E2)治疗,剂量为每日100微克。在E2治疗期开始前和结束时,测定了PTH对静脉注射氯化钙的反应性。通过测定血清E2和促卵泡激素(FSH)水平来检查治疗依从性。E2水平从0.1±0.02(平均值±标准误)升至0.46±0.10毫摩尔/升(p<0.01),而相应的FSH水平从77.5±7.4降至33.9±5.7U/升(p<0.01)。这表明依从性良好。在E2治疗期结束时,与对照值相比,补钙引起了更高的PTH抑制(PTH减量面积2123±270对1253±253纳克/升×分钟,p<0.05),尽管血钙反应较低(钙增量面积32.6±6.1对47.4±4.5毫摩尔/毫升×分钟,p<0.05)。这些结果表明,甲状旁腺依赖于充足的雌激素供应来对血清钙变化做出正常反应。

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