Relationship Between Estrogen Treatment and Skeletal Health in Women With Cystic Fibrosis.
Relationship Between Estrogen Treatment and Skeletal Health in Women With Cystic Fibrosis.
复制标题
囊性纤维化女性的雌激素治疗与骨骼健康之间的关系。
DOI：
10.1016/j.amjms.2020.06.005
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Tangpricha V
中科院分区：
文献类型：
--
作者：
Wu M;Bettermann EL;Arora N;Hunt WR;McCracken C;Tangpricha V
囊性纤维化（CF）患者有发生CF相关骨病的风险。患有CF的女性可能会因骨骼健康以外的原因使用雌激素补充剂。目前还不清楚雌激素治疗是否对CF女性的骨骼健康有有益的影响。在这项回顾性队列研究中，CF妇女在一个单一的CF中心，腰椎骨密度（BMD）的CF妇女暴露于补充和不暴露于补充雌激素进行了比较。样条函数模型包括雌激素暴露的主效应和年龄与雌激素补充之间的交互作用。在分析的145名受试者中：44名受试者暴露于补充雌激素。除了使用CFTR调节剂和抗骨质疏松药物外，雌激素暴露和未暴露受试者的基线特征相似。暴露于雌激素的女性在21岁左右达到峰值BMD，而未暴露于雌激素的女性在25岁左右达到峰值BMD。一个显着的年龄和雌激素补充剂的相互作用表明，腰椎骨密度轨迹不同的曝光组。我们的研究表明，很少有生育年龄的CF妇女接受雌激素治疗。此外，21岁之前的雌激素暴露与BMD改善相关，但21岁之后的雌激素暴露似乎与BMD改善无关。需要进一步的研究来了解CF年轻女性雌激素使用率低的原因以及雌激素处方的最佳时机，剂量和配方。
Patients with cystic fibrosis (CF) are at risk for CF-related bone disease. Women with CF may use estrogen supplementation for reasons other than skeletal health. It is unknown whether estrogen therapy has a beneficial impact on skeletal health in women with CF. In this retrospective cohort study of women with CF followed at a single CF center, the lumbar spine bone mineral density (BMD) of women with CF exposed to supplemental and not exposed to supplemental estrogen were compared. Spline function models included the main effect of estrogen exposure and the interaction between the age and estrogen supplementation. Of the 145 subjects analyzed: 44 subjects were exposed to supplemental estrogen. The baseline characteristics of estrogen exposed and unexposed subjects were similar except for use of CFTR modulators and anti-osteoporosis medications. Women exposed to estrogen reached peak BMD around 21 years of age, but women not exposed to estrogen reached peak BMD around 25 years of age. A significant interaction of age and estrogen supplementation indicated that the lumbar spine BMD trajectories differed by exposure group. Our study demonstrates that few women with CF of reproductive age are prescribed estrogen therapy. Furthermore, estrogen exposure up to age 21 is associated with improved BMD, but estrogen exposure after age 21 does not appear to be associated with improved BMD. Further studies are needed to understand the reasons for the low rates of estrogen use in young women with CF and the optimal timing, dose and formulation of estrogen prescription.
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影响因子：
5.2
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