Savaş ERDEM, Hüseyin Levent KESKİN, Ayşe Filiz AVŞAR YAVUZ, Gülin Feykan AKÇAY YEĞİN, Elçin SEÇEN İŞLEK

The effect of smoking on the response to raloxifene treatment in postmenopausal osteoporosis

Amaç: Bu çalışmada amacımız, postmenopozal osteoporoz tedavisinde raloksifen kullanan kadın-larda, sigaraiçiminin tedavinin etkinliğine olan etkisini incelemektir. Gereç ve yöntem: Bu kesitsel çalışmada, postmenopozal döneminde olan ve osteoporoz saptanan 88 (sigara içmeyen n= 54, sigara içen n= 34) olguya Raloksifen HCl(60 mg/gün) + 600 mg iyonize kalsiyum/gün + 400 IU vitD/gün tadavisi verildi. Tedavinin 1.yılı sonunda 63 olguda (Sigara içmeyen grup n= 39, Sigara içen grup n= 24)DEXA yöntemi kullanılarak L1-4 arası lomber vertebra, femur trokanter, femur boynu ve total kalça (hip) bölge- lerinde kemik mineral yoğunlukları (gr/cm2) ölçüldü ve Tskorları hesaplandı. İki grup arasında tedavi sonuçlarıkarşılaştırıldı. Sonuçlar: Raloksifen tedavisine başlanmadan önce heriki grubun ortalama yaş (55,8 ±3,3’e karşı 53,0 ±1,3 yıl),menopoz yaşları (49,3 ±2,9’a karşı 48,1 ±2,1 yıl) menopoz süresi (5,0 ±1,3’e karşı 7,0 ±1,4 yıl), vücut kütle indeksleri (27,2 ±3,7’e karşı 23,4 ±0,2 kg/m2) ve estradiol düzeyleri (26,0 ±3,7’e karşı vs 23,4 ±0,2) arasında anlamlı farklılık saptanmadı (p> 0,05). Tedavinin başlangıcında BMD değerleri tüm ölçüm bölgelerinde iki grup arasındafarklı değildi (p> 0,05). Raloksifenin BMD üzerine etkisi sigara içen ve içmeyen gruplara göre karşılaştırıldığında sigara içmeyen grupta tüm ölçüm bölgelerinde BMD değerlerinde belirgin düzelme saptanırken (p< 0,05), sigara içen grupta ise tüm ölçüm bölgelerinde başlangıç değerlerine göre anlamlı bir düzelme olmadığı görüldü (p>0,05). Sonuç: Sigara içmek raloksifenin BMD üzerine olan tedavi etkinliğini olumsuz yönde etkilemektedir.

Sigara içiminin postmenopozal osteoporozda raloksifen tedavi yanıtına etkisi

Objectives: The aim of this study was to examine the ef-fect of smoking on the efficacy of raloxifene treatment inpostmenopausal osteoporosis.Materials and methods: In this cross-sectional study,raloxifene HCl (60 mg/day) and 600 mg ionized calcium+ 400 IU vitamin D/day treatment were given to 63 cases(nonsmoker group n= 39, smoker group n= 24), who werein the postmenopausal period and detected as having os-teoporosis. At the end of the first year of the treatment, thebone mineral densities (BMDs; g/cm2) were measured atfour regions, namely the femur neck, femur trochanter, to-tal hip, and lumbar vertebrae between L1-4, and T-scoreswere determined. The changes in BMDs were comparedbetween the two groups.Results: Before starting the treatment, the mean ages(55.8 ± 3.3 vs. 53.0 ± 1.3 years), menopausal ages (49.3 ± 2.9 vs. 48.1 ± 2.1 years), postmenopausal periods (5.0± 1.3 vs. 7.0 ± 1.4 years), body mass indexes, and es- tradiol levels were found to be significantly not different between the two groups (p > 0.05). At the beginning of treatment, the BMD values were not different for all mea- sured regions in both groups (p > 0.05). At the end of the first year of the treatment, statistically significant improve- ments in BMD values and T-scores were detected for all measured regions in the nonsmoker group (p < 0.05). However, there were no significant differences in the BMD values from the initial values in the smoker group after treatment (p > 0.05).Conclusions: The treatment efficacy of raloxifene in im- proving BMD values in postmenopausal osteoporosis is negatively influenced by smoking. J Clin Exp Invest 2012; 3(4): 457-462

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