在青春期使用低剂量口服避孕药两年后,骨的影响
Lilian Rodrigues Orsolini1, Tamara Beres Lederer Goldberg1, Talita Domingues Caldeirão1
1Postgraduate Program in Tocogynecology, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
结合口服避孕药 (COC) 在青少年中的使用与非使用者相比,与骨质积累的减少有关. 较高剂量的乙inylestradiol (EE) 可能会加剧这种对青少年骨健康的负面影响.
科学领域:
- 内分泌学 在内分泌学.
- 青少年医学 青少年医学
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 关于荷尔蒙避孕药对青少年骨质的影响存在相互矛盾的数据.
- 组合口服避孕药 (COC) 被青少年广泛使用.
- 在COC使用期间评估骨代谢对于长期的骨健康至关重要.
研究的目的:
- 用两种类型的联合口服避孕药 (COC) 来评估健康青少年的骨代谢.
- 为了比较COC使用者和非使用者之间的骨质量和骨生物标志物.
主要方法:
- 一个非随机临床试验,涉及168名青少年超过两年.
- 组包括非使用者,使用者20微克EE/150微克Desogestrel (COC1) 和30微克EE/3毫克Drospirenone (COC2).
- 骨密度计 (DXA) 和骨生物标志物 (BAP,OC) 在基线和24个月测量.
主要成果:
- 非使用者显示明显更大的骨质结合 (腰部BMC:4.85g) 比COC1 (2.15g) 和COC2 (-0.43g).
- 在对照组 (100.83g) 和COC1 (21.46g) 中,亚总体BMC增加,但在COC2 (-1.47g) 中下降.
- 与对照组 (13.59 ng/mL) 相比,COC使用者 (COC1: 6.44 ng/mL,COC2: 9.48 ng/mL) 的骨质卡尔辛 (OC) 水平显著降低.
结论:
- 联合使用荷尔蒙避孕药会影响健康青少年的骨质.
- 对骨质的负面影响在较高的乙乙醇 (EE) 剂量 (30微克) 中显得更加明显.
- 需要进一步的研究来了解长期的骨影响.
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