Menopoz sonrası kadınlarda hormon replasman tedavi süreci ve reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri

Amaç: Menopoz sonrası kadınlarda hormon replasman tedavi (HRT) sürecinin ve parite, menopoz yaşı, menopoz süresi gibi reprodüktif faktörlerin kemik mineral yoğunluğu üzerine etkileri araştırıldı. Hastalar ve Yöntemler: Trakya Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Kliniği Menopoz Polikliniği'ne başvuran 322 menopoz sonrası kadının (ort. yaş 52.4±6.2; dağılım 38-76) yaş, reprodüktif öykü ve hormon replasmanı ile ilgili bilgileri arşivden çıkarıldı. Hastalar, östrojen kullanım süreleri ve halen kullanmakta olup olmadıklarına göre sınıflandırıldı ve bu özelliklerinin kemik mineral yoğunluğuna etkileri analiz edildi. Kadınların lomber vertebra, femur, trokanter ve wards kemik dansitometreleri DEXA (dual-energy X-ray absorpsiometri) yöntemiyle ölçüldü. Bulgular: Hormon replasman tedavisi kullanımı üç yıldan fazla olan menopoz sonrası kadınlardaki wards ve trokanter kemik mineral yoğunlukları, üç yıldan az olanlara göre anlamlı olarak yüksek bulundu. Vertebral kemik yoğunlukları, üç yılın üzerinde HRT kullananlarda hiç kullanmayanlara göre daha yüksek saptandı. Wards ve vertebral kemik yoğunluğu değerleri, halen HRT'yi kullanmakta olan ve üç yıldan daha uzun süredir kullananlarda hiç HRT kullanmamış kadınlara göre daha yüksek tespit edildi. Geçmişte HRT kullanıp sonradan bırakmış olan kadınlarda kemik mineral yoğunluğu değerleri hiç HRT kullanmamış olan kadınlardan farklı olmadığı bulundu.. Parite ve menopoz sonrasında geçen süre artışının kemik yoğunluğunu düşürdüğü görüldü. Sonuç: Vertebra ve kalça kemik mineral yoğunlukları, HRT kullanımının ancak üç yıl veya daha uzun süreli kullanımlarında ve HRT'nin kullanıldığı dönem içinde artmaktadır. Parite ve menopoz sonrası geçen süre ise osteoporoz riskini artıran faktörlerdir.

Anahtar Kelimeler:

Hormon replasman tedavisi, Östrojen replasman tedavisi, Kemik yoğunluğu, Postmenopoz, Geriyedönük çalışma

Hormone replacement therapy process and effects of reproductive factors on bone mineral density in postmenopausal women

Objectives: The effects of hormone replacement therapy (HRT) and reproductive factors such as parity, age of menopause, and duration of menopause on bone mineral density (BMD) in postmenopausal women were investigated. Patients and Methods: Age, reproductive history and HRT data of 322 postmenopausal women (mean age 52.4±6.2 years; range 38- 76) who applied to the outpatient menopause clinic of Trakya University Medical Faculty were gathered from the medical archives of the outpatient clinic. Patients were grouped according to the duration and current status of estrogen therapy and the effects of these variables on BMD were analysed. Bone mineral densities of lumbar spine, femur, trochanter, and Ward's triangle sites were measured by Dual Energy X-ray Absorptiometry (DEXA). Results: Bone mineral densities of trochanter, and Ward's triangle sites of postmenopausal women who received HRT for more than 3 years were found to be significantly higher than those women who were treated for less than 3 years. Vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years, compared to those women who were never treated with HRT. Ward's triangle and vertebral bone densities were significantly higher in postmenopausal women who received HRT for more than 3 years and those currently on HRT, compared to those women who never received HRT. BMD values of women who started but interrupted their HRTs, were similar to the values found in women who never received HRT. Increasing parity and duration of menopause were the factors that reduced BMD values. Conclusion: It appeared that BMD of hip and spine increased in postmenopausal women after the third or more years on HRT and during the period of treatment with HRT. Parity and duration of menopause were identified as factors which increase the risk of osteoporosis.

Keywords:

Hormone Replacement Therapy, Estrogen Replacement Therapy, Bone Density, Postmenopause, Retrospective Studies,

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