EFFECT OF HORMONE REPLACEMENT THERAPY ON BONE MASS IN RHEUMATOID-ARTHRITIS PATIENTS TREATED WITH AND WITHOUT STEROIDS
EFFECT OF HORMONE REPLACEMENT THERAPY ON BONE MASS IN RHEUMATOID-ARTHRITIS PATIENTS TREATED WITH AND WITHOUT STEROIDS
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DOI：
10.1002/art.1780371014
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发表时间：
1994-10-01
影响因子：
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通讯作者：
SPECTOR, TD
中科院分区：
文献类型：
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作者：
HALL, GM;DANIELS, M;SPECTOR, TD
Objective.评估激素替代疗法（HRT）对接受和未接受类固醇治疗的类风湿性关节炎（RA）患者骨量的影响。方法。200名绝经后RA妇女（年龄45-65岁）被随机分配接受经皮雌二醇（激素替代疗法;（HRT）（50 μ g/天）或钙补充剂（400 mg/天）2年。42例患者（21%）正在服用皮质类固醇。在研究开始时以及12个月和24个月时测量腰椎（BMDLS）和股骨近端（BMDLS）的骨密度。总体而言，HRT组24个月后平均BMDLS变化了+2.22%（95%置信区间[95% CI]+0.72，+3.72），平均BMDLS变化了-0.41%（95% CI-1.89，+1.07）。在钙组中，平均BMDLS变化-1.19%（95% CI-2.29，-0.09），平均BMDLS变化-0.56%（95% CI-2.60，+1.48）。治疗组间仅脊柱差异显著（P < 0.001）。21例激素替代治疗患者中，BMDLS增加3.75%（95%CI +0.72，+6.78），BMDLS增加1.62%（95%CI-1.27，+4.51）。这项研究表明，HRT增加脊柱骨密度和维持股骨骨密度在绝经后RA。激素替代疗法也是一种有效的药物，在保持骨量的患者服用低剂量皮质类固醇。
Objective. To assess the effect of hormone replacement therapy (HRT) on bone mass in rheumatoid arthritis (RA) patients treated with and those not treated with steroids.Methods. Two hundred postmenopausal women with RA (ages 45-65 years) were randomly allocated to receive transdermal estradiol (hormone replacement therapy; (HRT) (50 mu g daily) or calcium supplementation (400 mg daily) for 2 years. Forty-two of the patients (21%) were taking corticosteroids. Bone mineral density of the lumbar spine (BMDLS) and of the proximal femur (BMDF) was measured at study entry and at 12 months and 24 months.Results. In the HRT group overall, mean BMDLS had changed by +2.22% (95% confidence interval [95% CI] +0.72, +3.72) and mean BMDF by -0.41% (95% CI -1.89, +1.07) after 24 months. In the calcium group, mean BMDLS changed by -1.19% (95% CI -2.29, -0.09) and mean BMDF by -0.56% (95% CI -2.60, +1.48). Differences between treatment groups were significant for the spine only (P < 0.001). In the 21 HRT-treated patients taking steroids, BMDLS increased by 3.75% (95% CI +0.72, +6.78) and BMDF by 1.62% (95% CI -1.27, +4.51).Conclusion. This study shows that HRT increases spinal BMD and maintains femoral BMD in postmenopausal RA. HRT is also an effective agent in preserving bone mass in patients taking low-dose corticosteroids.