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停止更年期激素治疗和骨折风险:使用例行收集的初级保健数据进行嵌套病例对照研究
Yana Vinogradova1, Barbara Iyen1, Tahir Masud2
1Centre for Academic Primary Care, Lifespan & Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
The lancet. Healthy longevity
|July 27, 2025
概括
使用更年期激素治疗 (MHT) 的女性减少了骨折风险. 在停止MHT后,骨折风险最初上升,然后随着长期使用而显著下降,特别是在老年人中.
科学领域:
- 生殖医学 生殖医学
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 更年期激素治疗 (MHT) 与女性骨折风险降低有关.
- 有限的数据存在于MHT停止后骨折风险,特别是长期.
- 这项研究旨在估计过去的MHT用户在停药后长时间内骨折的风险.
研究的目的:
- 为了研究更年期荷尔蒙治疗停止后的长期骨折风险.
- 为过去的MHT用户提供可靠的骨折风险估计,随着他们的年龄增长.
主要方法:
- 一个嵌套的病例控制研究利用了英国的初级和二级保健数据 (CPRD GOLD和Aurum).
- 40岁以上有第一次骨折记录的女性与没有骨折的对照进行了匹配.
- 条件后勤回归分析了与MHT相关的骨折风险,并对混因素进行了调整.
主要成果:
- 与从未使用者相比,当前使用MHT与骨折风险降低有关.
- 在MHT discontinuation后的1-10年内,骨折风险增加,超过从未使用者的水平.
- 在戒药10年后,骨折风险低于从未使用过的人,特别是使用MHT持续时间较长的人.
结论:
- 在MHT停止后,骨折风险最初急剧增加,随后逐渐下降.
- 风险水平因MHT类型和持续时间而异,在停止后显著增加.
- 调查结果为有关MHT启动和停止的临床决策提供了信息,突出了骨折风险较高的时期.
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