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首页> 外文期刊>Women’s midlife health. >Bone mineral density in midlife long-term users of hormonal contraception in South Africa: relationship with obesity and menopausal status
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Bone mineral density in midlife long-term users of hormonal contraception in South Africa: relationship with obesity and menopausal status

机译：南非荷尔蒙避孕荷尔蒙避孕药中骨矿物密度：与肥胖和更年期的关系

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In South Africa, hormonal contraception is widely used in women over the age of 40?years. One of these methods and the most commonly used is depot-medroxyprogesterone acetate (DMPA) which has been found to have a negative effect on bone mass. Limited information is available on the effect of norethisterone enanthate (NET-EN) on bone mass, and combined oral contraceptives (COCs) have not been found to be associated with loss of bone mass. The aim of this study was to investigate bone mineral density (BMD) in pre and perimenopausal women (40-49?years) in relation to use of DMPA, NET-EN and COCs for at least 12?months preceding recruitment into the study and review associations with body mass index (BMI) and menopausal status. One hundred and twenty seven users of DMPA, 102 NET-EN users and 106 COC users were compared to 161 nonuser controls. Menopausal status was assessed, BMI and forearm BMD was measured at the distal radius using dual X-ray absorptiometry. Comparison analysis was conducted at baseline and 2.5?years. There was no significant difference in BMD between the four contraceptive user groups (p?=?0.26) with and without adjustment for age at baseline or at 2.5?years (p?=?0.52). The BMD was found to be significantly associated with BMI (p?=??0.0001) with an increase of one unit of BMI translating to an increase of 0.0044?g/cm2 in radius BMD. Follicle stimulating hormone (FSH) level?≥?25.8 mIU/mL was associated with a decrease of 0.017?g/cm2 in radius BMD relative to women with FSH ?25.8 mIU/mL. Significant interaction between FSH and BMI in their effect on BMD was observed (p?=?.006). This study found no evidence that long-term use of DMPA, NET-EN and COCs affects forearm BMD in this population at baseline or after 2.5?years of follow-up. This study also reports the complex relationship and significant interaction between FSH and BMI in their effect on BMD. BMD research in older women needs to ensure that women are assessed for menopausal status and BMI.
机译：在南非，荷尔蒙避孕药广泛用于40岁以上的女性。这些方法之一和最常用的是Depot-medroxypergerone乙酸盐（DMPA），其已被发现对骨质量产生负面影响。有限的信息可用于诺贝瑟恩·孕酸（Net-Zh）对骨质量的影响，并且没有发现组合口服避孕药（COCs）与骨量损失有关。本研究的目的是在预招募到研究中的使用DMPA，NET-ZH和COC，研究前周末妇女（40-49岁）（40-49岁）的骨密度（40-49岁）中的骨密度（BMD）。审查体重指数（BMI）和更年期状态的关联。与161个非用户控件进行比较了一百二十七名DMPA，102个网友用户和106克克斯用户。评估更年期状态，使用双X射线吸收测定法在远端半径处测量BMI和前臂BMD。比较分析在基线和2.5年进行。四个避孕用户组（P？= 0.26）之间没有显着差异，并且在基线或2.5岁处的年龄或2年（p？= 0.52）。发现BMD与BMI（P？=Δ0101）显着相关，随着一个单位的BMI平移到半径BMD中的增加0.0044Ω·G / cm2。卵泡刺激激素（FSH）水平？≥？25.8 mIU / ml与含有FSH <β25.8mIU / ml的女性的桡岛的半径BMD下降0.017Ω·G / cm2。观察到FSH和BMI之间对BMD效果之间的显着相互作用（P？= 006）。本研究发现没有证据表明，长期使用DMPA，NET-ZH和COCs在基线或2.5年后的前后随访后影响本人的前臂BMD。本研究还报告了对BMD影响的FSH和BMI之间的复杂关系和重大互动。老年女性的BMD研究需要确保对更年期状态和BMI进行评估妇女。

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