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低剂量异黄酮衍生物依普黄酮与雌激素替代疗法联合应用对绝经后女性骨密度及骨代谢的影响

Effects of combined low dose of the isoflavone derivative ipriflavone and estrogen replacement on bone mineral density and metabolism in postmenopausal women.

作者信息

Gambacciani M, Ciaponi M, Cappagli B, Piaggesi L, Genazzani A R

机构信息

Department of Obstetrics and Gynecology, University of Pisa, Italy.

出版信息

Maturitas. 1997 Sep;28(1):75-81. doi: 10.1016/s0378-5122(97)00059-5.

DOI:10.1016/s0378-5122(97)00059-5
PMID:9391998
Abstract

OBJECTIVES

To assess the pattern of biochemical markers of bone metabolism and vertebral bone mineral density in early postmenopausal women treated with combined ipriflavone and low dose conjugated estrogens.

METHODS

Bone biochemical markers and vertebral bone density were evaluated in a longitudinal, comparative, 2 year study conducted in postmenopausal women treated with sole calcium supplementation (500 mg/day), or with either ipriflavone (IP) at the standard dose (600 mg/day) plus the same calcium dose, low dose conjugated estrogens (CE) (0.3 mg/day) plus calcium, or low dose IP (400 mg/day) plus low dose CE (0.3 mg/day) plus calcium. The results were analyzed by repeated measures analysis of variance, as appropriate.

RESULTS

No modifications of both urinary excretion of hydroxyproline and plasma osteocalcin levels were observed in calcium and in CE-treated women, while vertebral bone density significantly decreased (P < 0.0001) in both groups. In IP or IP + CE-treated women, plasma osteocalcin did not show any modification, while urinary hydroxyproline showed a significant (P < 0.05) decrease, that paralleled a significant (P < 0.05) increase in vertebral bone density.

CONCLUSION

Postmenopausal IP administration, at the standard dose of 600 mg/day, can prevent the increase in bone turnover and the decrease in bone density that follow ovarian failure. The same effect can be obtained with the combined administration of low dose (400 mg/day) IP with low dose (0.3 mg/day) CE.

摘要

目的

评估联合使用异黄酮和低剂量结合雌激素治疗的绝经后早期女性的骨代谢生化标志物模式及椎骨骨密度。

方法

在一项为期2年的纵向、对比研究中,对接受单纯补钙(500毫克/天)、或标准剂量异黄酮(IP,600毫克/天)加相同钙剂量、低剂量结合雌激素(CE,0.3毫克/天)加钙、或低剂量IP(400毫克/天)加低剂量CE(0.3毫克/天)加钙治疗的绝经后女性,评估其骨生化标志物和椎骨骨密度。视情况通过重复测量方差分析对结果进行分析。

结果

补钙组和CE治疗组女性的羟脯氨酸尿排泄量和血浆骨钙素水平均未发生改变,而两组的椎骨骨密度均显著下降(P<0.0001)。在IP或IP+CE治疗组女性中,血浆骨钙素未显示任何变化,而尿羟脯氨酸显著下降(P<0.05),这与椎骨骨密度的显著增加(P<0.05)相一致。

结论

绝经后每天服用标准剂量600毫克的IP可预防卵巢功能衰竭后骨转换增加和骨密度降低。低剂量(400毫克/天)IP与低剂量(0.3毫克/天)CE联合使用也可获得相同效果。

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