卵巢切除术后骨代谢和脂质代谢的变化及雌激素替代疗法的影响

[Changes in bone and lipid metabolisms following oophorectomy and effects of estrogen replacement therapy].

作者信息

Nozaki M, Hashimoto K, Sumii Y, Ogata R, Yuuki H, Yokoyama M, Imura M, Sano M, Nakano H

机构信息

Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Fukuoka.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1993 Jan;45(1):38-44.

PMID:8382249

Abstract

The bone and lipid metabolisms in Japanese oophorectomized (OVX) women and effects of estrogen replacement therapy (ERT) were investigated. Three hundred and two OVX women (mean age of 41.6) and 164 premenopausal women (mean age of 42.1) were examined. BMD of the lumbar spine, serum Ca, P, Al-p, total cholesterol (T-C), HDL-C and LDL-C were measured every three months. BMD within 2 years after OVX was not significantly decreased. The mean BMD between 2 and 5 years or over 10 years after OVX was 0.83 (p < 0.01) and 0.69 (p < 0.001), respectively. Serum Ca and P were increased for 2 years and Al-p was increased for 10 years after OVX. To investigate the effect of ERT on BMD, OVX women were divided into 3 groups: ERT, VD3 and no treatment groups. After 12 months of treatment, the mean % BMD in each group was 102.9, 100.6 and 97.8, respectively. T-C or LDL-C was gradually increased in 10 years after OVX. After 15 months of ERT, the mean percentages HDL-C and LDL-C in hyperlipidemic women (LDL-C > or = 150) were 110.5 (p < 0.05) and 75.2 (p < 0.001). ERT may be requisite for OVX women and effective in preventing increased bone turnover and hyperlipidemism following OVX.

摘要

研究了日本卵巢切除（OVX）女性的骨代谢和脂质代谢以及雌激素替代疗法（ERT）的效果。对302名OVX女性（平均年龄41.6岁）和164名绝经前女性（平均年龄42.1岁）进行了检查。每三个月测量一次腰椎骨密度、血清钙、磷、碱性磷酸酶（Al-p）、总胆固醇（T-C）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）。OVX后2年内骨密度无显著下降。OVX后2至5年或10年以上的平均骨密度分别为0.83（p<0.01）和0.69（p<0.001）。OVX后血清钙和磷升高2年，Al-p升高10年。为研究ERT对骨密度的影响，将OVX女性分为3组：ERT组、维生素D3组和未治疗组。治疗12个月后，每组的平均骨密度百分比分别为102.9、100.6和97.8。OVX后10年内T-C或LDL-C逐渐升高。ERT治疗15个月后，高脂血症女性（LDL-C≥150）的HDL-C和LDL-C平均百分比分别为110.5（p<0.05）和75.2（p<0.001）。ERT可能是OVX女性所必需的，并且在预防OVX后骨转换增加和高脂血症方面有效。