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Tytuł:
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Timing and dosage of and adherence to hormone replacement therapy and fracture risk in women with menopausal syndrome in Taiwan: A nested case-control study.
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Autorzy:
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Chang CY; Division of Minimal Invasive Endoscopy Surgery, Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan; Department of Medicine, China Medical University, Taichung, Taiwan.
Tsai FJ; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan.
Chiou JS; Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Chiu ML; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Lin TH; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Liao CC; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Huang SM; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
Liang WM; Department of Health Services Administration, China Medical University, Taichung, Taiwan. Electronic address: .
Lin YJ; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address: .
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Źródło:
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Maturitas [Maturitas] 2021 Apr; Vol. 146, pp. 1-8. Date of Electronic Publication: 2021 Jan 08.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Limerick : Elsevier/North Holland Biomedical Press
Original Publication: Amsterdam, Elsevier/North Holland Biomedical Press.
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MeSH Terms:
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Hormone Replacement Therapy*
Estrogens/*administration & dosage
Fractures, Bone/*prevention & control
Progestins/*administration & dosage
Aged ; Case-Control Studies ; Drug Administration Schedule ; Female ; Fractures, Bone/epidemiology ; Humans ; Medication Adherence ; Menopause ; Middle Aged ; Odds Ratio ; Taiwan/epidemiology
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Contributed Indexing:
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Keywords: Adherence; Cumulative defined daily dose; Fracture; Hormone replacement therapy; Menopausal syndrome; Nested case-control study
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Substance Nomenclature:
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0 (Estrogens)
0 (Progestins)
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Entry Date(s):
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Date Created: 20210316 Date Completed: 20210503 Latest Revision: 20210503
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Update Code:
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20240104
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DOI:
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10.1016/j.maturitas.2020.12.010
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PMID:
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33722358
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Objective: To investigate the association between hormone replacement therapy (HRT) and the risk of bone fracture in menopausal women in Taiwan.
Study Design: The longitudinal, population-based, nested case-control study in Taiwan involved 5269 women aged > 45 years with fractures and 21,076 matched randomly selected controls without fractures. A conditional logistic regression model of analysis was employed.
Main Outcome Measures: The association between the risk of bone fracture and various HRT-related parameters, including the timing, dosage, and adherence, was investigated.
Results: Women with menopausal syndrome were protected from fractures when they received hormone drugs at high cumulative defined daily doses (DDDs) (Cumulative DDDs≥360) (odds ratio [OR]: 0.90, 95 % confidence interval [CI]: 0.82-0.99) and when their adherence was high (over 0.5) (OR: 0.70, 95 % CI: 0.60-0.82). The risk of fracture also decreased with high cumulative DDDs and high adherence combined (OR: 0.71, 95 % CI: 058-0.86). Subgroup analyses suggested that estrogen-containing regimens showed a protective effect against fractures at high cumulative DDDs or when adherence was high. Similar results were also observed with progestogen-containing regimens. Past exposure to an estrogen-containing regimen showed a protective effect against fractures when adherence was high. Past exposure to a progestogen-containing regimen showed a protective effect against fractures at high cumulative DDDs and when adherence was high.
Conclusions: The results indicate that past exposure to estrogen-containing or progestogen-containing regimens exerts protective effects against bone fracture. These effects increased with higher cumulative DDDs and with adherence in a dose-dependent manner.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
