首次使用长效醋酸甲羟孕酮患者2年中骨密度的改变

摘要

To compare longitudinal changes in bone mineral density (BMD) among first-tim e depot medroxyprogesterone acetate (DMPA) users to women using no hormonal cont raception, and evaluate user characteristics associated with that BMD change. Pr ospective longitudinal study. Healthy volunteers in an academic research environ ment. Women, aged 18 to 35, choosing DMPA for contraception (n = 178) and women using no hormonal contraception (n = 145). Hip and spine BMD measured, at three -month intervals for 24 months, by dual energy x-ray absorptiometry. Mean hip BMD declined 2.8%(SE = 0.034) 12 months following DMPA initiation and 5.8%(SE = 0.096) after 24 months. Mea n spine (L1-L3) BMD declined 3.5%(SE = 0.022) and 5.7%(SE = 0.034), respectiv ely, after one and two years of DMPA use. Mean hip and spine BMD of control part icipants changed less than 0.9%over the same period. Among DMPA users, body mas s index (BMI) change was inversely associated with BMD change at the hip, but no t at the spine. Calcium intake, physical activity, and smoking did not influence BMD change in either group. Hip and spine BMD declined after one DMPA injection and this decline continued with each subsequent injection for 24 months. With t he exception of increasing BMI among DMPA users, no user characteristics offered protection against DMPA-related BMD loss.