Nozaki M, Inoue Y, Hashimoto K, Ogata R, Nakano H
Department of Gynecology and Obstetrics, Kyushu University, Fukuoka, Japan.
Int J Gynaecol Obstet. 1998 Jan;60(1):41-6. doi: 10.1016/s0020-7292(97)00235-x.
The effects of conjugated equine estrogen (CEE) on bone mineral density (BMD) and biochemical indices of bone remodeling in oophorectomized women were studied for 3 years during estrogen replacement therapy (ERT) to investigate whether 0.625 mg/day of CEE alone prevent acute bone loss in the early stage of surgical menopause.
We divided the subjects into three groups according to interval between oophorectomy and the start of ERT (group 1: less than 2 years after surgery, n = 31; group 2: 2-5 years after surgery, n = 29; and group 3: more than 5 years after surgery, n = 27). Vertebral BMD was measured using dual energy X-ray absorptiometry (DEXA). Two biochemical indices of bone metabolism, urinary deoxypyridinoline (DPyr) and serum intact human osteocalcin (hOC) were also measured.
In group 1, continuous ERT with 0.625 mg/day of CEE could not prevent a BMD decrease within the first year. However, by the end of the second year, BMD was restored to the pre-ERT. The same dosage of CEE significantly increased BMD in groups 2 and 3 by the end of the first year. DPyr and hOC levels both decreased dramatically in the initial 6 months of therapy and were stable thereafter.
In the initial 2-year period after oophorectomy, 0.625 mg/day of CEE alone could not prevent acute bone loss suggesting that additional therapy for the prevention of osteoporosis may be needed.
在雌激素替代疗法（ERT）期间，对去卵巢女性使用共轭马雌激素（CEE）3年，研究其对骨密度（BMD）和骨重塑生化指标的影响，以调查每天0.625 mg的CEE能否单独预防手术绝经早期的急性骨质流失。
根据去卵巢手术与开始ERT的间隔时间将受试者分为三组（第1组：术后不到2年，n = 31；第2组：术后2 - 5年，n = 29；第3组：术后超过5年，n = 27）。使用双能X线吸收法（DEXA）测量椎体骨密度。还测量了两个骨代谢生化指标，尿脱氧吡啶啉（DPyr）和血清完整人骨钙素（hOC）。
在第1组中，每天0.625 mg的CEE持续ERT在第一年内无法预防BMD下降。然而，到第二年年底，BMD恢复到ERT前水平。相同剂量的CEE在第1年末使第2组和第3组的BMD显著增加。DPyr和hOC水平在治疗的最初6个月均显著下降，此后保持稳定。
在去卵巢手术后的最初2年期间，每天0.625 mg的CEE单独无法预防急性骨质流失，提示可能需要额外的骨质疏松预防治疗。
