Hänggi W, Lippuner K, Jaeger P, Birkhäuser M H, Horber F F
Department of Gynaecology and Obstetrics, University of Bern, Switzerland.
Clin Endocrinol (Oxf). 1998 Jun;48(6):691-9. doi: 10.1046/j.1365-2265.1998.00481.x.
To compare the effects on body composition and body weight of tibolone vs two different sequential oral or transdermal oestrogen-progestogen hormone replacement therapies versus no therapy.
One hundred postmenopausal women were assigned to a control group (n = 26), or randomized to 1) tibolone (TIB) 2.5 mg/day (n = 28), 2) oral oestradiol 2 mg/day (PO) plus sequential dydrogesterone 10 mg/day for 14 of 28 days per cycle (n = 26), or 3) transdermal oestradiol patch (TTS) releasing 50 micrograms/day plus oral sequential dydrogesterone 10 mg/day for 14 of 28 days per cycle (n = 20). Body composition was measured at the base-line and every 6 months for 2 years by DXA (Hologic QDR 1000 W).
Total body fat mass increased (P < 0.05) in controls (+3.6 +/- 1.5%) and in TTS treated (+4.7 +/- 2.2%), but not in PO (-1.2 +/- 2.4%) and TIB (-1.6 +/- 2.2%) treated subjects. This increase in total fat mass in controls and TTS treated women was mostly due to an increase in fat mass of the trunk (P < 0.05), but not legs. As a result, a redistribution of body fat to the trunk occurred in controls, TTS and TIB, but not in PO treated women (P < 0.05). Total lean body mass decreased (P < 0.02) in controls (-1.7 +/- 0.7%) and PO (-1.4 +/- 0.6%) but not in TTS (+0.3 +/- 0.8%) and TIB (+0.4 +/- 0.5%) treated subjects.
The menopause is associated with an increase in total body fat and a decline in lean body mass. Oral oestradiol/dydrogesterone and tibolone prevent total body fat changes, whereas transdermal oestradiol/oral dydrogesterone and tibolone prevent the lean mass changes. Furthermore, oral oestradiol/dydrogesterone prevents the shift to a central, android fat distribution.
比较替勃龙与两种不同的序贯口服或经皮雌激素 - 孕激素激素替代疗法以及不进行治疗对身体成分和体重的影响。
100名绝经后女性被分配至对照组（n = 26），或随机分为1）替勃龙（TIB）2.5毫克/天（n = 28），2）口服雌二醇2毫克/天（PO）加序贯地屈孕酮10毫克/天，每周期28天中使用14天（n = 26），或3）经皮雌二醇贴片（TTS），释放量为50微克/天加口服序贯地屈孕酮10毫克/天，每周期28天中使用14天（n = 20）。通过双能X线吸收仪（Hologic QDR 1000 W）在基线时以及2年中每6个月测量一次身体成分。
对照组（增加3.6±1.5%）和接受经皮雌二醇贴片治疗组（增加4.7±2.2%）的全身脂肪量增加（P < 0.05），而接受口服雌二醇/地屈孕酮治疗组（减少1.2±2.4%）和替勃龙治疗组（减少1.6±2.2%）的全身脂肪量未增加。对照组和接受经皮雌二醇贴片治疗的女性全身脂肪量的增加主要是由于躯干脂肪量增加（P < 0.05），而非腿部。因此，对照组、经皮雌二醇贴片治疗组和替勃龙治疗组均出现了身体脂肪向躯干的重新分布，而接受口服雌二醇/地屈孕酮治疗的女性未出现（P < 0.05）。对照组（减少1.7±0.7%）和接受口服雌二醇/地屈孕酮治疗组（减少1.4±0.6%）的瘦体重总量下降（P < 0.02），而接受经皮雌二醇贴片治疗组（增加0.3±0.8%）和替勃龙治疗组（增加0.4±0.5%）的瘦体重总量未下降。
绝经与全身脂肪增加和瘦体重下降有关。口服雌二醇/地屈孕酮和替勃龙可防止全身脂肪变化，而经皮雌二醇/口服地屈孕酮和替勃龙可防止瘦体重变化。此外，口服雌二醇/地屈孕酮可防止身体脂肪向中心型、男性型脂肪分布转变。
