INJECTABLE CONTRACEPTIVES AND BONE ULTRASOUND MEASURES

描述(由申请者提供)：对以白人为主的人群的一些研究 建议注射孕激素避孕药(IPC)的使用者， Depot-甲羟孕酮醋酸酯(DMPA)，骨密度低于 非用户。这在生物学上是可信的，因为DMPA的使用会导致 雌激素水平。在一项研究中，骨密度的差异 吸毒者和非吸毒者之间的差异集中在18-21岁的女性中， 他们的峰值骨密度还没有达到，但在另一个 研究发现骨丢失与年龄无关。一种不可逆转的影响 骨骼上的IPC将对骨质疏松的比率产生严重影响 在以后的生活中，特别是对于年轻时使用IPC的妇女来说，骨折是可能的。 南非的黑人(非洲)和有色人种(混血)妇女 长期使用IPC的比率非常高，其中约80%是DMPA，20%是 百分比炔诺酮酯酸酯。脚后跟的超声骨骼测量是 有很强的骨折征兆。我们将进行一项横断面研究 超声声学测量的跟骨与IPC使用之间的关系 大开普敦18-44岁的黑人和有色人种绝经前妇女， 南非。其目的是评估IPC是否与较低的 超声波测量脚后跟的骨骼。我们还将评估是否存在不利的 停用后效果下降，无论是否集中在 年轻女性，以及它是否与使用这两种药物的时间有关 现任或前任用户。将对DMPA和炔诺酮双酯进行评估。 关于口服避孕药使用情况和其他相关因素的信息(例如，口服避孕药 吸烟、体重指数、饮酒、体力活动、 哺乳、牛奶摄入量和生殖史)将通过以下方式获得 个人采访：将测量身高和体重。这项研究将评估 使用时间比以往任何一项研究都要长。应该注意的是，一个 不同族裔群体之间的IPC效果可能有所不同。我们的研究将是第一个 信息性评估黑人和有色人种女性的脚后跟骨量 不同于彼此和/或白人女性。 全世界数以百万计的妇女使用了IPC。鉴于……的沉重负担 老年妇女骨质疏松性骨折，对公共卫生具有重要意义 确定IPC是否对骨骼有不利影响。

DESCRIPTION (provided by applicant): Some studies of largely white populations suggest that users of the injectable progestogen contraceptive (IPC), depot-medroxyprogesterone acetate (DMPA), have lower bone mineral density than nonusers. This has biologic credibility because DMPA use results in decreased levels of estrogen. In one study, the difference in bone mineral density between users and nonusers was concentrated in women aged 18-21 years, among whom peak bone mineral density would not yet have been achieved, but in another study there was no relation of the bone loss to age. An irreversible effect of IPCs on bone would have serious implications for rates of osteoporotic fractures later in Life, particularly for women who used IPCs at young ages. Black (African) and colored (mixed racial descent) women in South Africa have very high rates of long-term IPC use, about 80 percent of which is DMPA and 20 percent norethisterone enanthate. Ultrasound bone measurements of the heel are strongly predictive of fractures. We will conduct a cross-sectional study of heel bone as measured by ultrasound sonometry in relation to IPC use among black and colored premenopausal women aged 18-44 years in greater Cape Town, South Africa. The aim is to assess whether IPCs are associated with lower ultrasound heel bone measurements. We will also assess whether an adverse effect decreases after cessation of use, whether it is concentrated among younger women, and whether it is related to the duration of use in either current or ex-users. Both DMPA and norethisterone enanthate will be assessed. Information on IPC use and other relevant factors (e.g., oral contraceptive use, cigarette smoking, body mass index, alcohol use, physical activity, lactation, milk intake, and reproductive history) will be obtained through personal interview: height and weight will be measured. The study will assess longer durations of use than any previous study. It should be noted that an effect of IPCs may differ between ethnic groups. Our study will be the first to informatively assess black and colored women whose heel bone measurements differ from each other and/or those of white women. Millions of women worldwide have used IPCs. Given the heavy burden of osteoporotic fractures in elderly women, it is of public health importance to determine whether IPCs have an adverse effect on bone.