Nozaki M, Hashimoto K, Inoue Y, Ogata R, Okuma A, Nakano H
Department of Gynecology and Obstetrics, Kyushu University, Fukuoka, Japan.
Int J Gynaecol Obstet. 1998 Jul;62(1):69-75. doi: 10.1016/s0020-7292(98)00068-x.
We previously reported that 0.625 mg/day of conjugated equine estrogen (CEE) could not prevent acute bone loss in the first year after oophorectomy. The effect of additional administration of ipriflavone on bone mineral density (BMD) and biochemical indices of bone remodeling were studied to investigate whether concurrent use of CEE and ipriflavone prevent acute bone loss in the early stages following surgical menopause.
One-hundred and sixteen oophorectomized women were randomly divided into four groups according to treatment; group 1: placebo, n = 30; group 2: CEE (0.625 mg/day), n = 29; group 3: ipriflavone (600 mg/day), n = 30; group 4: CEE (0.625 mg/day) plus ipriflavone (600 mg/day), n = 27. Vertebral BMD was measured using dual energy X-ray absorptiometry (DEXA) and two biochemical indices of bone metabolism, urinary pyridinoline (Pyr) and serum intact human osteocalcin (hOC), were also measured before, 24 weeks, and 48 weeks after initiation of treatment.
BMD was reduced 48 weeks after treatment by 6.1, 3.9 and 5.1% in groups 1-3, respectively, but by only 1.2% in group 4. Pyr decreased by 49.5, 32.0 and 41.5% in groups 2-4, respectively. hOC also decreased by 45.2 and 21.6% in groups 2 and 4, but increased by 40.5% in group 3, suggesting an inhibitory action of CEE and ipriflavone on the turnover of bone metabolism and stimulatory action of ipriflavone on bone formation.
Concomitant use of ipriflavone with CEE from an early stage after oophorectomy inhibited bone loss and was considered to be effective in maintaining bone mass after oophorectomy.
我们之前报道过，每天服用0.625毫克结合马雌激素（CEE）无法预防卵巢切除术后第一年的急性骨质流失。本研究旨在探讨在手术绝经后的早期阶段，联合使用异黄酮是否能预防急性骨质流失，研究了额外服用异黄酮对骨矿物质密度（BMD）和骨重塑生化指标的影响。
116名接受卵巢切除术的女性根据治疗方法随机分为四组；第1组：安慰剂，n = 30；第2组：CEE（0.625毫克/天），n = 29；第3组：异黄酮（600毫克/天），n = 30；第4组：CEE（0.625毫克/天）加异黄酮（600毫克/天），n = 27。在治疗开始前、24周和48周，使用双能X线吸收法（DEXA）测量椎体BMD，并测量骨代谢的两个生化指标，尿吡啶啉（Pyr）和血清完整人骨钙素（hOC）。
治疗48周后，第1 - 3组的BMD分别降低了6.1%、3.9%和5.1%，而第4组仅降低了1.2%。第2 - 4组的Pyr分别降低了49.5%、32.0%和41.5%。第2组和第4组的hOC也分别降低了45.2%和21.6%，但第3组增加了40.5%，这表明CEE和异黄酮对骨代谢转换有抑制作用，而异黄酮对骨形成有刺激作用。
卵巢切除术后早期联合使用异黄酮与CEE可抑制骨质流失，被认为对维持卵巢切除术后的骨量有效。
