한국 폐경 여성에서 경피 에스트로겐 겔 치료의 효과
Effects of Transdermal Estrogen Gel in Postmenopausal Korean Women
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초록
연구목적: 한국 폐경 여성에서 경피 에스트로겐 겔 투여 효과를 조사하였다. 연구재료 및 방법: 49명의 페경 여성에서 경피 에스트로겐 제형인 겔 (0.1%, 매일 1.5 mg 투여) 1년간 호르몬 치료를 시행하였다. 치료 3개월 뒤 폐경 증상의 호전 정도를 치료 전과 비교하였고, 부작용의 발생을 평가하였다. 체중, 체질량지수, 허리 둘레와 같은 신체측정 및 콜레스테롤, lipoprotein(a), 공복혈당, fibrinogen, C-반응성 단백질 및 deoxypyridinoline과 같은 대사 인자들을 치료 시작 3, 6, 12개월 후에 측정하여 치료 전 수치와 비교하였다. 이와 함께 치료 6개월 및 12개월 후 요추 및 대퇴 경부에서 골밀도를 측정하여 치료 시작 전과 비교하였다. 결과: 치료 3개월 후 폐경 증상이 유의하게 감소하였으며, 이 기간 동안 가장 흔한 부작용은 유방과 관련된 증상들이었고 (32.1%), 다음으로는 두통 (17.8%) 및 피부 자극 (14.3%)이 흔하였다. 1년 간의 호르몬 치료 기간 중 신체측정 결과에는 변화가 없었던 반면, 혈중 총 콜레스테롤, 저밀도 지단백, 공복 혈당 및 deoxypyridinoline 농도는 유의하게 감소하였다. 아울러, 요추 부위의 골밀도 역시 유의하게 증가하였다. 결론: 한국 폐경 여성에서 경피 에스트로겐인 겔을 이용한 호르몬 치료는 폐경 증상을 호전시키고, 대사 및 골에 유익한 영향이 있다.
Abstract
Objectives: To evaluate the effects of transdermal estrogen gel on postmenopausal Korean women. Methods: In this retrospective study, 49 healthy postmenopausal women were treated with transdermal gel (0.1%, 1.5 mg/day +/- progestogen) for 1 year. After 3 months of transdermal hormone therapy (HT), deviations from baseline of the global index for menopausal symptoms and the frequency of side effects were evaluated. Anthropometric factors including weight, body mass index, waist circumference, and metabolic parameters (such as serum cholesterol, lipoprotein(a), fasting glucose, fibrinogen, C-reactive protein, and deoxypyridinoline levels) were measured at baseline and after three, six, and twelve months of HT. In addition, bone mineral density was also measured at the lumbar spine and femoral neck at baseline and after six and twelve months of HT. Differences between baseline values and subsequent post-HT measurements were compared. Results: After 3 months of transdermal HT, the global index for menopausal symptoms decreased significantly (P < 0.001). Side effects within 3 months included problems related to the breast, which were most common (32.1%), followed by headache (17.8%) and skin irritation (14.3%). Anthropometric factors did not change after HT, however, metabolic parameters creased significantly. There was a notable increase in bone mineral density at the lumbar spinebut not at the femoral neck. Conclusion: Transdermal gel HT improves menopausal symptoms and metabolic parameters in postmenopausal Korean women and increases bone mineral density at the lumbar spine.
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