수술 후 인공 폐경 여성에서 아이소플라본의 영향
Effects of Isoflavone on Surgically Menopaused Women
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목적 : 최근 호르몬 대체요법 대신 그 사용이 증가하고 있는 식물성 에스트로겐이 단기 에스트로겐 결핍증상과 혈중 지질변화, 골 대사 물질에 어떠한 영향을 주는지 알아보고자 한다. 연구 방법 : 2002년 11월-2003년 10월에 가톨릭대학교 부속 성모병원 산부인과에서 양성의 부인과 질환으로 전 자궁 적출술 및 양측 자궁부속기 적출술을 받은 폐경 전 여성들을 무작위로 세 그룹으로 나누었다. 첫번째 그룹은 수술 후 호르몬 제제를 투약하지 않았으며 (이하 대조군), 두번째 그룹은 conjugated equine estrogen 0.625 mg을 3개월간 투약하였으며 (이하 에스트로겐군), 세번째 그룹은 아이소플라본 100 mg을 3회 분복하여 3개월간 투약하였다 (이하 아이소플라본군). 수술 전과 수술 12주 후 Kupperman's 지수와 요실금 점수, 골 대사 물질, 혈중 지질을 측정하여 비교하였다. Kupperman's 지수와 요실금 점수는 점수가 높을수록 증상이 심함을 나타낸다. 결과 : 수술 12주째 3개월 후 세군 모두에서 Kupperman's 지수와 요실금 점수가 모두 상승하였는데, 대조군에서 각각 6/8.5점 상승하여, 에스트로겐군의 1.5/1.0점, 아이소플라본군의 1.3/1.5점에 비해 유의한 차이를 나타내었다 (p<0.05). 혈중 지질의 변화를 보면, 전체 콜레스테롤과 중성지방은 세군 모두에서 증가하여 유의한 차이를 보이지 않았으며 (p>0.05) HDL 콜레스테롤은 에스트로겐과 아이소플라본 양군에서 수술 후 3개월째 모두 증가하는 소견을 보였다. 골 대사 인자인 osteocalcin은 에스트로겐군과 아이소플라본군에서 대조군에 비해 감소하는 소견을 보였으며, 대조군에서는 높게 증가하는 소견을 나타내었다. 골 흡수 인자인 ICTP는 에스트로겐군에서 감소 소견을, 대조군과 아이소플라본군에서는 약간 증가하는 소견을 나타내었다. 결론 : 아이소플라본은 급성 에스트로겐 결핍증상에 효과가 있으며, 비뇨생식계의 위축증상을 개선한다. 혈중 지질과 골밀도에 대해서도 어느 정도 유의한 효과가 있다.
Abstract
Objective : To evaluate the effects of isoflavone intake on estrogen deprivated symptoms in surgically menopaused women. Methods : Premenopausal women who took total hysterectomy with both adnexectomy were randomized into three groups. One group took conjugated equine estrogen 0.625 mg daily for 12 weeks after surgery, the second group took isoflavone 100 mg #3 daily for 12 weeks after surgery, and the third group took no medication for controlled group. Questionnaires about the acute menopausal symptoms, incontinence score, blood lipid profile, bone turnover marker were checked before and 12 weeks after surgery. Results : Kupperman's index and insentience score were showed less increased rate than control group. Total cholesterol and triglyceride were increased in all groups and HDL cholesterol was increased in estrogen and isoflavone groups. Osteocalcin was decreased in estrogen and isoflavone groups, ICTP was decreased in estrogen group, and increased in the other groups. Conclusion : Isoflavone was effective to acute postmenopusal symptoms, urogenital atrophy and bone turnover.
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