Effects of menopausal hormone therapy on bone mineral density in women of different menopausal ages and modes
Objective To investigate the effects of menopausal hormone therapy(MHT)on bone mineral density(BMD)in women with different menopausal ages and modes.Methods A total of 869 postmenopausal women admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2012 to December 2021 were selected as study subjects,and they were divided into 40-44 years old group(n=127),45-49 years old group(n=348),50-54 years old group(n=305),55-59 years old group(n=89)according to menopause age,and then according to the treatment modality into the group of MHT group(n=521)and non-MHT group(n=348),and then according to the treatment time,they were divided into＜1 year group(n=94),1-＜3 years group(n=258),3-＜5 years group(n=110),and ≥5 years group(n=59).The lumbar(L1-L4)BMD,femoral BMD,and T-value of the study participants were observed,and the effects of MHT on BMD in women with different menopausal ages,menopausal modes,and treatment time were analyzed.Results There were significant differences in lumbar(L1-L4)BMD,femoral BMD and T values among women of different menopause age groups(F=3.205,3.807 and 4.558,respectively,P＜0.05),the earlier menopause age,the lower the BMD.The lumbar(L1-L4)BMD,femoral BMD,and T values of surgical menopausal patients in the 40-44 and 45-49 age groups were significantly lower than those of naturally menopausal patients,and the differences were statistically significant(t=2.490,2.550,2.907,2.210,2.308 and 2.775,respectively,P＜0.05),there was no significant difference in lumbar(L1-L4)BMD,femoral BMD,and T values between the 50-54 and 55-59 age groups(t=1.009,1.121,1.209,0.701,0.865 and 0.962,respectively,P＞0.05).The lumbar(L1-L4)BMD,femoral BMD,T-value of MHT group were significantly higher than those of non-MHT group,and the differences were statistically significant(t=3.769,4.120 and 4.303,respectively,P＜0.05).The BMD of lumbar spine(L1～L4)and femoral BMD were significantly higher after MHT treatment in different menopausal age groups than before treatment,and the differences were statistically significant(t=2.579-4.018,P＜0.05).The prevalence of low bone mass and osteoporosis were lower than that before treatment in MHT group after 2 years of treatment,and the differences were statistically significant(X2=24.563 and 4.262,respectively,P＜0.05),while there was no significant difference in the prevalence of low bone mass and osteoporosis in the non-MHT group(X2=1.357 and 1.043,respectively,P＞0.05).The lumbar(L1-L4)BMD,femoral BMD,and T values of the natural menopausal MHT group were significantly higher than those of the non-MHT group,and the differences were all statistically significant(t=2.450,2.637 and 3.102,respectively,P＜0.05).The increased values of lumbar(L1-L4)BMD,femoral BMD,and T value were more obvious in the surgically menopausal MHT group,and the differences were all statistically significant(t=4.079,4.202 and 4.615,respectively,P＜0.01).With the prolongation of the treatment time,the increased values of lumbar(L1-L4)BMD,femoral BMD,and T value of the MHT groups with different time were all significantly higher,and the differences were statistically significant(F=3.508,3.946 and 4.785,respectively,P＜0.05).Conclusion MHT can significantly improve BMD in postmenopausal women,the more significant effect were observed when MHT was used earlier.Postmenopausal women should start MHT as early as possible after excluding contraindicated syndrome under the guidance of professional doctors,especially young women after surgical menopause.
menopausal hormone therapymenopausal agemenopause modebone mineral densityeffects
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