Characterization of perimenopausal bone loss: A prospective study
Characterization of perimenopausal bone loss: A prospective study
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DOI：
10.1359/jbmr.2000.15.10.1965
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发表时间：
2000-10-01
影响因子：
6.2
通讯作者：
Heaney, R
中科院分区：
文献类型：
--
作者：
Recker, R;Lappe, J;Heaney, R
这项研究的特点是骨量，骨标志物，垂体/性腺激素，维生素D，甲状旁腺激素和人体测量变量在一个队列的健康妇女，因为他们通过正常的绝经期的变化。我们招募了75名年龄> 46岁的妇女，她们具有绝经前雌二醇（E-2）和促性腺激素水平，月经规律。在9.5年的观察中，54人经历了正常绝经（PM组），21人保持雌激素充足（ER组）。在绝经期下降开始之前和结束之后，PM组中脊柱骨量的时间斜率为0%，全身骨量的时间斜率为每年-0.61%，股骨颈骨量的时间斜率为每年-0.45%。将这些损失指定为“年龄相关”，在数据分析的8年期间，脊柱、全身骨矿物质（TBBM）和股骨颈的损失分别为0、4. 88和3. 40%。在绝经期，我们发现PM组的骨丢失呈S形模式，开始于末次月经前约2-3年，结束于末次月经后约3-4年。总雌激素剥夺骨丢失分别为10.50，7.73，和5.30%的脊柱，TBBM，股骨颈，分别。在ER组中，我们发现脊柱、TBBM和股骨颈的年丢失率分别为0、0.59和0.93%。PM组血清骨钙素升高77%，血清总碱性磷酸酶升高34%，尿羟脯氨酸/肌酐（Hypro/Cr）比值升高44%，而ER组保持稳定。我们的结论是，绝经期骨质流失是一个复合损失所造成的雌激素剥夺和年龄本身的髋关节和全身，但所造成的雌激素剥夺单独的脊柱。
This study characterized the change in bone mass, bone markers, pituitary/gonadal hormones, vitamin D, parathyroid hormone, and anthropometric variables in a cohort of healthy women as they passed through normal menopause. We recruited 75 women > 46 years old who had premenopausal estradiol (E-2) and gonadotropin levels and regular menses. During 9.5 years of observation, 54 experienced normal menopause (PM group) and 21 remained estrogen replete (ER group). Before the beginning of the menopausal drop and after its completion, the slope of bone mass on time in the PM group was 0% for the spine, -0.61% per year for the total body, and -0.45% per year for the femoral neck. Designating these losses as "age related," there were 0, 4.88, and 3.40% losses for spine, total body bone mineral (TBBM), and femoral neck, respectively, in the 8-year period for which the data were analyzed. Across menopause, we found a sigmoid pattern of bone loss in the PM group beginning about 2-3 years before the last menses and ending about 3-4 years after the last menses. The total estrogen-deprivation bone losses were 10.50, 7.73, and 5.30% for the spine, TBBM, and femoral neck, respectively. In the ER group, we found a 0, 0.59, and 0.93% per year loss in spine, TBBM, and femoral neck, respectively. Serum osteocalcin rose 77%, serum total alkaline phosphatase rose 34%, and urinary hydroxyproline/creatinine (Hypro/Cr) ratio rose 44% in the PM group, while remaining stable in the ER group. We conclude that menopausal bone loss is a composite of loss caused by estrogen deprivation and age per se for the hip and total body, but is caused by estrogen deprivation alone for the spine.