Low-Dose Esterified Estrogen Therapy: Effects on Bone, Plasma Estradiol Concentrations, Endometrium, and Lipid Levels
Low-Dose Esterified Estrogen Therapy: Effects on Bone, Plasma Estradiol Concentrations, Endometrium, and Lipid Levels
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低剂量酯化雌激素治疗：对骨、血浆雌二醇浓度、子宫内膜和脂质水平的影响
DOI：
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Nolan Jc
中科院分区：
文献类型：
--
作者：
H. Genant;J. Lucas;S. Weiss;M. Akin;R. Emkey;H. McNaney;R. Downs;J. Mortola;N. Watts;Yang Hm;N. Banav;J. Brennan;Nolan Jc
背景：前瞻性研究表明，需要相当于 0.625 mg/d 或更高剂量的结合马雌激素才能显着增加腰椎骨矿物质密度。目的：确定非拮抗酯化雌激素对骨矿物质密度、脂质水平和子宫内膜组织结构的影响，并将这些影响与血浆雌二醇水平的变化联系起来。方法：406 名绝经后妇女接受 1000 毫克/天的钙治疗，并随机分配接受连续酯化雌激素（0.3、0.625 或 1.25 毫克/天）或安慰剂，为期 24 个月。每 6 个月进行一次骨矿物质密度测量以及子宫内膜和实验室评估； 12、18和24个月后测量血浆雌二醇浓度。结果：与基线和安慰剂相比，所有剂量的酯化雌激素在 6、12、18 和 24 个月时腰椎骨矿物质密度均显着增加。平均血浆雌二醇水平随着酯化雌激素剂量的增加而增加，并且个体受试者骨矿物质密度的变化似乎与血浆雌二醇浓度相关。仅在每天接受 0.625 毫克和 1.25 毫克酯化雌激素的组中才注意到子宫内膜增生的临床相关率。脂质变化与剂量相关并且在所有组中都很明显。结论：酯化雌激素剂量为 0.3 至 1.25 mg/d，在不受孕激素抵抗的情况下，对骨骼和脂质产生连续的积极变化。血浆雌二醇浓度随着酯化雌激素剂量的增加而增加，并且与正骨矿物质密度相关。 0.3毫克剂量导致骨和脂质发生积极变化，但不引起子宫内膜增生。拱门实习医生。 1997;157:2609-26155
Background: Prospective studies have shown that doses equivalent to conjugated equine estrogens of 0.625 mg/d or higher are needed to produce a significant increase in bone mineral density of the lumbar spine. Objectives: To determine the effects of unopposed esterified estrogens on bone mineral density, lipid levels, and endometrial tissue structure, and to relate these effects to changes in plasma estradiol levels. Methods: Four hundred six postmenopausal women were given calcium, 1000 mg/d, and randomly assigned to receive continuous esterified estrogens (0.3, 0.625, or 1.25 mg/d) or placebo for 24 months. Bone mineral density measurements and endometrial and laboratory assessments were conducted every 6 months; plasma estradiol concentrations were measured after 12, 18, and 24 months. Results: All doses of esterified estrogens produced significant increases in bone mineral density of the lumbar spine compared with baseline and with placebo at 6,12, 18, and 24 months. Mean plasma estradiol levels increased with esterified estrogens dose, and individual subject bone mineral density changes appeared related to plasma estradiol concentrations. Clinically relevant rates of endometrial hyperplasia were noted only in the groups receiving 0.625 and 1.25 mg of esterified estrogens daily. Lipid changes were dose related and apparent in all groups. Conclusions: Esterified estrogens at doses from 0.3 to 1.25 mg/d, administered unopposed by progestin, produce a continuum of positive changes on bone and lipids. Plasma estradiol concentrations increased with esterified estrogens dose and were related to positive bone mineral densities. The 0.3-mg dose resulted in positive bone and lipid changes without inducing endometrial hyperplasia. Arch Intern Med. 1997;157:2609-26155
影响因子：
158.5
作者：
Grodstein, F;Stampfer, MJ;Hennekens, CH
通讯作者：
Hennekens, CH
雌激素/孕激素治疗：预防和治疗绝经后骨质疏松症。
DOI：
10.3181/00379727-191-42920
发表时间：
1989
期刊：
Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N.Y.)
影响因子：
--
作者：
Lindsay,R
通讯作者：
Lindsay,R
影响因子：
5
作者：
MELTON, LJ;KAN, SH;RIGGS, BL
通讯作者：
RIGGS, BL