INJECTABLE CONTRACEPTIVES AND BONE ULTRASOUND MEASURES

描述（由申请方提供）：一些主要针对白色人群的研究 建议注射孕激素避孕药（IPC）的使用者， 醋酸甲羟孕酮（DMPA），骨密度低于 非用户。这具有生物学可信度，因为DMPA的使用导致 雌激素水平在一项研究中， 使用者和非使用者之间的差异集中在18-21岁的妇女， 骨密度峰值尚未达到，但在另一个 研究表明，骨丢失与年龄无关。不可逆转的影响 骨的IPC将对骨代谢的发生率产生严重影响。 骨折以后的生活，特别是对妇女谁使用IPC在年轻的时候。 南非的黑人（非洲人）和有色人种（混合种族血统）妇女 长期使用IPC的比例非常高，其中约80%是DMPA，20%是 %炔诺酮庚酸酯。脚后跟的超声波骨骼测量结果是 强烈预示着骨折我们将进行一项横向研究， 通过超声声测法测量的与IPC使用相关的跟骨， 大开普敦18-44岁的黑人和有色人种绝经前妇女， 南非目的是评估IPC是否与较低的 超声波跟骨测量。我们还将评估是否存在不利的 停止使用后效果下降，无论是集中在 年轻女性，以及它是否与使用时间有关， 现任或前任用户。将评估DMPA和庚酸炔诺酮。 关于IPC使用和其他相关因素的信息（例如，口服避孕 使用，吸烟，体重指数，饮酒，体育活动， 哺乳期、牛奶摄入量和生殖史）将通过 个人面试：测量身高和体重。该研究将评估 使用时间比以往任何研究都长。应当指出， IPC的影响可能因种族而异。我们的研究将是第一个 信息评估黑人和有色人种妇女， 彼此不同和/或与白色女性不同。 全世界有数百万妇女使用过IPC。鉴于沉重的负担， 老年妇女骨质疏松性骨折，这是公共卫生的重要性， 确定IPC是否对骨骼有不良影响。

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.