Waller K, Reim J, Fenster L, Swan S H, Brumback B, Windham G C, Lasley B, Ettinger B, Marcus R
Reproductive Epidemiology Section, California Department of Health Services, Berkeley, USA.
J Clin Endocrinol Metab. 1996 Feb;81(2):663-8. doi: 10.1210/jcem.81.2.8636286.
Women with occasional anovulatory or short luteal phase menstrual cycles have been reported to lose bone mineral density (BMD) at a greatly accelerated rate compared to women without such abnormalities. To investigate this association, we performed a longitudinal study of BMD in a group of healthy premenopausal women enrolled in a comprehensive study of ovulatory function. Subjects had collected daily urine samples that were analyzed for estrone and progesterone metabolites by enzyme-linked immunoassay. The 53 participants collected urine for an average of 4.1 cycles. Computer algorithms identified 7 (13.2%) women with luteal phase abnormalities (> 1 anovulatory cycle or cycle with luteal phase length < or = 10 days) and 17 (32.1%) women with other menstrual abnormalities. Areal BMD (grams per cm2) was measured at the lumbar spine, hip, and whole body using dual energy x-ray absorptiometry; BMD was measured 2-3 times over an average observation period of 17.5 months. At baseline, women with luteal abnormalities had mean BMD similar to those of the 29 women with no abnormal cycles: lumbar spine, 1.06 vs. 1.09 g/cm2; total hip, 0.95 vs. 0.94 g/cm2; whole body, 1.15 vs. 1.11 g/cm2 (P > 0.10; adjusted for age and weight at baseline, parity, physical activity level, and calcium intake). When compared at follow-up to women with no abnormal cycles, women with luteal abnormalities tended to gain BMD at the spine and hip (P > 0.10). On whole body measurement, women with luteal abnormalities tended to lose BMD compared to women with no abnormal cycles (-1.1%/yr vs. 0%/yr; P = 0.08); however, the magnitude of loss was not unusual for women in this age range and was within the coefficient of variation for replicate measurements. Neither mean luteal phase length, percent time in luteal phase, nor average daily excretion of progesterone metabolites was associated with baseline BMD or percent annual change in BMD at any measurement site. Thus, we did not confirm a relationship between luteal abnormalities and accelerated bone loss in this population of healthy premenopausal women.
据报道，与没有此类异常情况的女性相比，偶尔出现无排卵或黄体期短的月经周期的女性骨矿物质密度（BMD）流失速度大大加快。为了研究这种关联，我们对一组参与排卵功能综合研究的健康绝经前女性进行了BMD纵向研究。受试者每天收集尿液样本，通过酶联免疫吸附测定法分析其中的雌酮和孕酮代谢物。53名参与者平均收集尿液样本4.1个周期。计算机算法识别出7名（13.2%）黄体期异常的女性（>1个无排卵周期或黄体期长度≤10天的周期）和17名（32.1%）有其他月经异常的女性。使用双能X线吸收法测量腰椎、髋部和全身的面积骨密度（克/平方厘米）；在平均17.5个月的观察期内进行2至3次BMD测量。在基线时，黄体期异常的女性的平均BMD与29名月经周期无异常的女性相似：腰椎，分别为1.06和1.09克/平方厘米；全髋，分别为0.95和0.94克/平方厘米；全身，分别为1.15和1.11克/平方厘米（P>0.10；根据基线年龄、体重、产次、身体活动水平和钙摄入量进行调整）。在随访时与月经周期无异常的女性相比，黄体期异常的女性在脊柱和髋部有增加BMD的趋势（P>0.10）。在全身测量中，与月经周期无异常的女性相比，黄体期异常的女性有BMD流失的趋势（-1.1%/年对0%/年；P=0.08）；然而，流失幅度在这个年龄范围内的女性中并不异常，且在重复测量的变异系数范围内。黄体期平均长度、黄体期时间百分比或孕酮代谢物的平均每日排泄量均与任何测量部位的基线BMD或BMD的年度变化百分比无关。因此，我们没有证实这群健康绝经前女性中黄体期异常与加速骨质流失之间的关系。
