首页 | 本学科首页   官方微博 | 高级检索  
     


Effects of continuous combined hormone replacement therapy and clodronate on bone mineral density in osteoporotic postmenopausal women: A 5-year follow-up
Authors:Marjo Tuppurainen,Kirsi Hä  rmä  ,Marja Komulainen,Vesa Kiviniemi,Heikki Krö  ger,Risto Honkanen,Esko Alhava,Jukka Jurvelin,Seppo Saarikoski
Affiliation:1. Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland;2. Bone and Cartilage Research Unit, Clinical Research Center, University of Eastern Finland, Kuopio, Finland;3. Central Hospital of South Karelia, Lappeenranta, Finland;4. IT Centre, University of Eastern Finland, Kuopio, Finland;5. Departments of Orthopedics and Traumatology and Handsurgery, Kuopio University Hospital, Kuopio, Finland;6. Institute of Clinical Medicine, Surgery, University of Eastern Finland, Kuopio, Finland;g Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
Abstract:

Objective

To determine the effects of HRT with or without clodronate on bone mineral density (BMD) change and bone turnover markers.

Design

Prospective, partly randomized trial.

Setting

Kuopio University Hospital, Finland.

Population

167 osteoporotic women (61 ± 2.7 years; T-score ≤ −2.5 SD).

Methods

Estradiol 2 mg + NETA 1 mg, randomization to additional 800 mg clodronate (n = 55, HT + C-group) or placebo (n = 55, HT-group); if contraindications to HRT, clodronate (n = 57, C-group).

Main outcome measures

BMD by DXA after 1, 3 and 5 years, serum osteocalcin (OC) and bone-specific alkaline phosphatase (BAP) at the baseline and after 3 years.

Results

After 5 years, adjusted lumbar BMD increased by 4.2% in the HT-group and 3.7% in the HT + C-group. The C-group showed a decrease of −1.1%, the total difference being 5.3% and 4.8% between HT, HT + C vs. C-group, respectively (p < 0.001). In the femoral neck, the adjusted 5-year BMD benefit was 1.3% and 2.4% in the HT- and HT + C-groups, respectively, the net loss of BMD in the C-group was −3.3% (p < 0.05 between HT + C vs. C). By 3 years, OC decreased by 55.0%, 70.3% and 53.8% in the HT-, HT + C- and C-groups, respectively (p < 0.001 vs. baseline). The significant decreases of BAP were 39.4% in the HT-group, 42.1% in the HT + C-group and 30.2% in the C-group with no significant differences between the groups after adjustments.

Conclusions

In postmenopausal women with osteoporosis, HRT increased spinal and femoral BMD, but the combination of HRT and clodronate did not offer an extra gain of bone mass.
Keywords:HRT   Clodronate   Menopause   BMD   Osteoporosis
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号