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Respuesta de la densidad mineral ósea al reemplazo de estrógenos en mujeres ancianas frágiles: un ensayo controlado
D T Villareal1, E F Binder, D B Williams
1Division of Geriatrics and Gerontology, Washington University School of Medicine, 4488 Forest Park Blvd, St Louis, MO 63108, USA. dvillare@im.wustl.edu
JAMA
|August 22, 2001
Resumen
La terapia de reemplazo hormonal (TRH) aumentó significativamente la densidad mineral ósea (DMO) en mujeres ancianas frágiles. Este estudio sugiere que la TRH puede ser una estrategia eficaz de prevención de la osteoporosis para esta población.
Área de la Ciencia:
- Gerontología Gerontología.
- Endocrinología Endocrinología.
- Investigación de la osteoporosis Investigación de la osteoporosis.
Sus antecedentes:
- La terapia de reemplazo hormonal (TRH) es reconocida para la prevención de la osteoporosis.
- Existen datos limitados sobre los efectos osteoprotectores de la TRH en mujeres ancianas frágiles.
Objetivo del estudio:
- Evaluar el impacto de la TRH en la densidad mineral ósea (DMO) en mujeres ancianas frágiles.
- Para determinar si la TRH puede aumentar la DMO en este grupo demográfico específico.
Principales métodos:
- Un ensayo aleatorizado, doble ciego y controlado con placebo de 9 meses.
- Se trataba de 67 mujeres mayores de 75 años con fragilidad leve a moderada.
- Se evaluaron los cambios en la DMO en la columna lumbar y la cadera utilizando absorptiometría de rayos X de doble energía.
Principales resultados:
- La TRH aumentó significativamente la DMO de la columna lumbar (4,3% frente a 0,4%) y la DMO total de la cadera (1,7% frente a -0,1%) en comparación con el placebo.
- La TRH condujo a reducciones significativas en los marcadores de la rotación ósea: fosfatasa alcalina específica ósea en suero (-24% vs 6%) y N-telopéptido en orina (-48% vs 4%).
Conclusiones:
- Nueve meses de TRH mejoraron significativamente la DMO en mujeres ancianas frágiles.
- Se requiere más investigación para determinar si estas mejoras en la DMO se traducen en una reducción del riesgo de fracturas.
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