The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal
The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal
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DOI：
10.1007/s00198-006-0259-y
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发表时间：
2007-04-01
影响因子：
4
通讯作者：
Reid, I. R.
中科院分区：
文献类型：
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作者：
Bolland, M. J.;Ames, R. W.;Reid, I. R.
我们对先前为期2年的氢氯噻嗪对骨密度影响的随机对照试验进行了为期2年的扩展。在前2年观察到的骨密度改善在整个扩展研究期间持续。噻嗪类利尿剂可减少尿钙排泄，因此可预防骨质疏松症。此前我们报道了一项在185名绝经后妇女中进行的为期2年的氢氯噻嗪治疗随机对照试验，该试验显示氢氯噻嗪对骨密度有积极的益处。在这里，我们报告的结果，为期2年的扩展到该study.Methods的185名健康绝经后妇女，122同意继续在一个双盲2年的扩展，每天服用50毫克氢氯噻嗪或安慰剂。骨密度测量发生在每6个月和钙代谢在2和4 years.Results骨密度的改善，在第2年的试验中看到的持续整个扩展。在全身（0.9%，P < 0.001）、腿部（1.0%，P= 0.002）、前臂中段（1.1%，P =0.03）和前臂超远端（1.4%，P=0.04）的骨密度变化方面，4年内组间差异有统计学意义。在腰椎（0.9%，P=0.76）和股骨颈（0.4%，P=0.53）的组间差异没有达到统计学显着性。结论氢氯噻嗪产生小的积极效益，皮质骨密度，至少持续前4年的治疗。它们为预防绝经后骨质流失提供了进一步的选择，特别是对于高血压或有肾结石病史的女性。
We performed a 2-year extension of our previous 2-year randomized controlled trial of the effects of hydrochlorothiazide on bone mineral density. The improvements in bone density seen in the first 2 years were sustained throughout the extension study. Thiazides provide a further option in the prevention of postmenopausal bone loss.Introduction Thiazide diuretics reduce urinary calcium excretion and therefore might prevent osteoporosis. Previously we reported a 2-year randomized controlled trial of hydrochlorothiazide treatment in 185 postmenopausal women that showed positive benefits of hydrochlorothiazide on bone density. Here, we report the results of a 2-year extension to that study.Methods Of 185 healthy postmenopausal women, 122 agreed to continue in a double-blinded 2-year extension taking 50 mg hydrochlorothiazide or placebo daily. Measurements of bone density occurred every 6 months and of calcium metabolism at 2 and 4 years.Results The improvements in bone density seen in the first 2 years of the trial were sustained throughout the extension. There were significant between-groups differences in the change in bone density over 4 years at the total body (0.9%, P < 0.001), legs (1.0%, P=0.002), mid-forearm (1.1%, P=0.03), and ultradistal forearm (1.4%, P=0.04). At the lumbar spine (0.9%, P=0.76) and femoral neck (0.4%, P=0.53) the between-groups differences did not reach statistical significance.Conclusions Hydrochlorothiazide produces small positive benefits on cortical bone density that are sustained for at least the first 4 years of treatment. They provide a further option in the prevention of postmenopausal bone loss, especially for women with hypertension or a history of kidney stones.