한국인 폐경후 여성에서 Tibolone과 활성형 비타민 D 병합요법이 골밀도에 미치는 영향

Abstract

Background: Tibolone is a novel synthetic compound with tissue-specific effects in bone, breast tissue and the endometrium. Tibolone, and active vitarmin D, effectively prevent bone loss, and the maintain skeletal integrity of postmenopausal women. The aim of the present study was to examine the effect of tibolone, and active vitamin D(1-hydroxyvitamin D3), therapies given alone, or in combination, against bone loss in postmenopausal women. Methods: One hundred and three postmenopausal women were treated with tibolone(n=40), alphacalcidol(n=27) or both drugs(n=36) for 12months. All subjects took supplemental calcium carbonate(500mg daily). The bone mineral densities(BMD) of the lumbar spine and proximal femur were measured by dual-energy x-ray absorptiometry(DXA) at the baseline and after 12 months. Results: Tibolone therapy produced significant increase of 4.1 and 1.8% in the BMD at the lumbar spine (p<0.001) and femoral neck (p=0.009), respectively. The combination of tibolone and active vitamon D increased the BMD by 8.0 and 4.4%(p<0.001)at the spine and femoral neck, respectively. The differences in the change of BMD from the baseline at the lumbar spine was significant(p=0.038) in the combination treatment group compared that in the tibolone alone group. Conclusion: Tibolone alone, and in combination with active vitamin D, effectively increased the BMD at all skeletal sites in postmenopausal women. Combination treatment for osteoporsis is emerging as a promising modality in Korean postmenopausal women