Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri

Yucel, Aykan; UÇAR, Banu; SAĞSÖZ, Nevin; NOYAN, Volkan

Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri

Banu UÇAR, (Kırıkkale Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Kırıkkale, Türkiye)

Nevin SAĞSÖZ, (Kırıkkale Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Kırıkkale, Türkiye)

Volkan NOYAN, (Kırıkkale Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Kırıkkale, Türkiye)

Aykan YÜCEL (Kırıkkale Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Kırıkkale, Türkiye)

Medical Network Klinik Bilimler ve Doktor

2 0

Yıl: 2005 Cilt: 11 Sayı: 5 Sayfa Aralığı: 548 - 553 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri

Öz:

Amaç: Bu çalışmada postmenopozal sağlıklı kadınlarda intranazal kalsitonin ile kombine verilen tibolon, konjuge estrojen, konjuge estrojen ve medroksiprogesteron asetat kullanımının kemik mineral yoğunluğuna etkisinin prospektif araştırılmasını amaçladık. Gereç ve Yöntem: Ekim 2002-Mart 2003 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum polikliniğine başvuran 37 postmenopozal sağlıklı kadın çalışmaya alındı. L2-L4 vertebra t skoru -1.5'den küçük olan kadınlar çalışmaya dahil edildi. Hastalar 3 gruba ayrıldı. Grup I'deki 14 kadına 2.5 mg/gün tibolon, grup II'deki 15 kadına 0.625 mg/gün konjuge estrojen (CEE)+2.5 mg/gün medroksiprogesteron asetat (MPA), grup III'deki histerektomize 8 kadına 0.625 mg/gün konjuge estrojen verildi. Tedavilerine günlük intranazal 200 İÜ/gün salmon kalsitonin ile 1500 mg/gün elementer kalsiyum ve 400 İÜ/gün vitamin D eklendi. Hastaların tedavi öncesi ve tedaviden 1 yıl sonraki dual-energy X-ray absorptiometry ile kemik mineral yoğunluğu (gr/cm²) ölçüldü. İstatistiksel analizler için paired t-test, one-way analysis of variance test, Kruskal-Wallis test kullanıldı. Bulgular: Lumbar vertebra kemik mineral yoğunluğunda tedavi başlangıcına göre grup I'de L2-L4: %0.22, L3 %0.46; grup II'de L2-L4: %0.38, L3: %0.46; grup III'de L2-L4: %0.30, L3: %0.63 anlamlı artış bulundu. Femur boynu kemik mineral yoğunluğunda tedavi başlangıcına göre grup I'de %0.12, grup II'de %0.12, grup III'de %0.10 anlamlı olmayan artış tesbit edildi. Başlangıca göre lumbar vertebra ve femur boynu kemik mineral yoğunluğundaki artışta gruplar arasında anlamlı fark tesbit edilmedi. Sonuç: Bu çalışmada, erken postmenopozal dönemde tibolon, CEE+MPA veya sadece CEE'nin, kalsitonin ile kombine kullanımda kemik mineral yoğunluğuna etkilerinin birbirlerine üstünlüğü gösterilememiştir.

Anahtar Kelime: Kombine tedavi uygulaması Kalsitonin Kemik yoğunluğu Postmenopoz Kemik hastalıkları, metabolik Hormon replasman tedavisi

Konular: Kadın Hastalıkları ve Doğum Genel ve Dahili Tıp Hematoloji Kadın Araştırmaları

The effects of intranasal calcitonin in combination with different hormone replacement therapy regimens on bone mineral density in postmenopausal osteopenic women

Öz:

Objective: The aim of the present study was to examine the effects of tibolone, conjugated estrogen plus medroxyprogesterone acetate and conjugated estrogen in combination with intranasal calcitonin on bone mineral density in postmenopausal healthy women. Material and Method: Thirty-seven healthy postmenopausal women who were attending to the clinic of Obstetrics and Gynecology, Kırıkkale University School of Medicine, between October 2002-March 2003, with lumbar L2-L4 t score less than -1.5, were participated in the study. The patients were seperated into three groups. Group I (n=14) was treated with 2.5 mg/day tibolone per os, group II (n=15) received 0.625 mg/day conjugated estrogen plus 2.5 mg/day medroxyprogesterone acetate per os and group III (n=8) received 0.625 mg/day conjugated estrogen per os. Hysterectomized women in group III were given only conjugated estrogen. Intranasal salmon calcitonin 200 IU/day per os, elementary calcium 1500 mg/day per os and vitamin D 400 IU/day were added to each treatment regimen. Bone mineral density of the lumbar spine (L2-L4, L3) and femoral neck were measured by dual energy X-ray absorptiometry at baseline and at the end of 12 months. Statistical analyses were performed using paired t test, one-way analysis of variance test, Kruskal-Wallis test. Results: The end of the treatment period, L2-L4 vertebral bone mineral density measurements significantly increased 0.22% in group I, 0.38% in group II and 0.30% in group III compared to baseline. L3 vertebral bone mineral density measurements significantly increased 0.46% in group I, 0.46% in group II and 0.63% in group III compared to baseline. Femoral neck bone mineral density measurements did not increased significantly 0.12% in group I, 0.12% in group II and 0.10% in group III compared to baseline. No significant difference was found in bone mineral density changes among the groups. Conclusion: In this study, the combination of calcitonin with tibolone, conjugated estrogen plus medroxyprogesterone acetate or conjugated estrogen alone were found to have similar effects on bone mass in early postmenopausal osteopenic women.

Anahtar Kelime: Hormone Replacement Therapy Combined Modality Therapy Calcitonin Bone Density Postmenopause Bone Diseases, Metabolic

Konular: Kadın Hastalıkları ve Doğum Genel ve Dahili Tıp Hematoloji Kadın Araştırmaları

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	UÇAR B, SAĞSÖZ N, NOYAN V, Yucel A (2005). Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. , 548 - 553.
Chicago	UÇAR Banu,SAĞSÖZ Nevin,NOYAN Volkan,Yucel Aykan Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. (2005): 548 - 553.
MLA	UÇAR Banu,SAĞSÖZ Nevin,NOYAN Volkan,Yucel Aykan Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. , 2005, ss.548 - 553.
AMA	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. . 2005; 548 - 553.
Vancouver	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. . 2005; 548 - 553.
IEEE	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A "Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri." , ss.548 - 553, 2005.
ISNAD	UÇAR, Banu vd. "Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri". (2005), 548-553.

APA	UÇAR B, SAĞSÖZ N, NOYAN V, Yucel A (2005). Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. Medical Network Klinik Bilimler ve Doktor, 11(5), 548 - 553.
Chicago	UÇAR Banu,SAĞSÖZ Nevin,NOYAN Volkan,Yucel Aykan Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. Medical Network Klinik Bilimler ve Doktor 11, no.5 (2005): 548 - 553.
MLA	UÇAR Banu,SAĞSÖZ Nevin,NOYAN Volkan,Yucel Aykan Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. Medical Network Klinik Bilimler ve Doktor, vol.11, no.5, 2005, ss.548 - 553.
AMA	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. Medical Network Klinik Bilimler ve Doktor. 2005; 11(5): 548 - 553.
Vancouver	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri. Medical Network Klinik Bilimler ve Doktor. 2005; 11(5): 548 - 553.
IEEE	UÇAR B,SAĞSÖZ N,NOYAN V,Yucel A "Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri." Medical Network Klinik Bilimler ve Doktor, 11, ss.548 - 553, 2005.
ISNAD	UÇAR, Banu vd. "Postmenopozal osteopenik kadınlarda intranazal kalsitonin ile kombine hormon replasman tedavi rejimlerinin kemik mineral dansitesi üzerine etkileri". Medical Network Klinik Bilimler ve Doktor 11/5 (2005), 548-553.