rhPTH(1-84)对甲状旁腺机能减退和绝经后骨质疏松症患者骨密度和骨小梁骨评分的比较研究。

PubMed ID
发表日期 2018年12月

原始出处 骨与矿物质研究杂志:美国骨与矿物研究学会的官方刊物
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
作者 Cipriani  Cristiana  Pepe  Jessica  Silva  Barbara C  Rubin  Mishaela R  Cusano  Natalie E  McMahon  Donald J  Nieddu  Luciano  Angelozzi  Maurizio  Biamonte  Federica  Diacinti  Daniele  Hans  Didier  Minisola  Salvatore  Bilezikian  John P 

文献标题 rhPTH(1-84)对甲状旁腺机能减退和绝经后骨质疏松症患者骨密度和骨小梁骨评分的比较研究。
Comparative Effect of rhPTH(1-84) on Bone Mineral Density and Trabecular Bone Score in Hypoparathyroidism and Postmenopausal Osteoporosis.

文献摘要

甲状旁腺激素(PTH)(1-84)改善甲状旁腺功能减退症患者腰椎(LS)的面骨密度(aBMD)和骨小梁评分(TBS)。骨质疏松症的研究表明,甲状旁腺激素(1-34)可显著增加LS-aBMD和TBS。本文提供了重组人甲状旁腺激素治疗甲状旁腺激素(PTH)18例患者与同期甲状旁腺激素(PTH)治疗甲状旁腺激素(PTH)的疗效比较。我们研究了19例绝经前(平均年龄45.8±11.8岁)和16例绝经后(71±8.4岁)甲状旁腺功能低下妇女和38例绝经后骨质疏松症妇女(71±8.3岁)。在LS、股骨颈、全髋关节和桡骨远端三分之一处进行DXA(hologic)评估。使用TBS iNsight软件(2.1版;Medimaps,Geneva,Switzerland)从未识别的脊椎DXA扫描中提取匹配的LS TBS数据。我们观察到绝经前和绝经后甲状旁腺机能减退(3      1.1%,p  0.02和3.1 1.4%,p 0.05)和骨质疏松症(6.2± 1.1%,p 0.0001)患者的LS-aBMD显著增加。绝经前甲状旁腺功能减退患者的TBS显著增加(3±1.5%,p = 0.05)。两组绝经后TBS均无变化。绝经后甲状旁腺功能减退(-3.6±1.1%,p<0.01)和骨质疏松症患者(8±1.4%,p<0.0001),aBMD显著下降。总的来说,在调整基线值、年龄、BMI和rhPTH的平均日剂量(1-84)后,绝经前甲状旁腺机能减退患者的TBS显著高于骨质疏松症患者(p<<0.0001)。仅与绝经后妇女相比,骨质疏松症患者的LS-aBMD增加幅度大于甲状旁腺功能减退组(p<0.01)。我们的研究结果表明,在甲状旁腺功能减退和绝经后骨质疏松症患者中,rhPTH(1-84)治疗18个月可增加骨小梁aBMD,骨质疏松症患者可观察到更大的增益。数据表明,甲状旁腺激素对骨骼的影响不同,这取决于骨骼的基本结构、骨骼动力学、隔室和绝经状态。©2018美国骨与矿物研究学会。


Parathyroid hormone (PTH) (1-84) improves lumbar spine (LS) areal bone mineral density (aBMD) and trabecular bone score (TBS) in hypoparathyroidism over a 2-year treatment period. Studies in osteoporosis have shown that with PTH(1-34) there is a significant increase in LS aBMD and TBS. In this article, we provide new data comparing the effects of the same form of PTH, namely recombinant human PTH, rhPTH(1-84), on aBMD and TBS in hypoparathyroid and osteoporotic patients over an 18-month treatment period. We studied 19 premenopausal (mean age 45.8 ± 11.8 years) and 16 postmenopausal (71 ± 8.4 years) hypoparathyroid women and 38 women with postmenopausal osteoporosis (71 ± 8.3 years). DXA (hologic) at LS, femoral neck, total hip, and distal one-third radius was assessed. Site-matched LS TBS data were extracted from deidentified spine DXA scans using the TBS iNsight software (version 2.1; Medimaps, Geneva, Switzerland). We observed a significant increase in LS aBMD in premenopausal and postmenopausal hypoparathyroid (3 ± 1.1%, p < 0.02 and 3.1 ± 1.4%, p < 0.05, respectively) and osteoporosis (6.2 ± 1.1%, p < 0.0001) patients after 18 months. There was a significant increase (3 ± 1.5%, p = 0.05) in TBS in premenopausal hypoparathyroid patients. A change in TBS was not observed in either postmenopausal group. One-third radius aBMD significantly declined in postmenopausal hypoparathyroid (-3.6 ± 1.1%, p < 0.01) and osteoporosis (-8 ± 1.4%, p < 0.0001) patients. Overall, there was a significantly greater increase in TBS in premenopausal hypoparathyroid than in osteoporosis patients (p < 0.0001) after adjusting for baseline values, age, BMI, and average daily dose of rhPTH(1-84). Comparing only postmenopausal women, the LS aBMD increase was greater in osteoporotic than hypoparathyroid subjects (p < 0.01). Our results demonstrate that rhPTH(1-84) administered for 18 months increases trabecular aBMD in hypoparathyroidism and postmenopausal osteoporosis with greater gains observed in the subjects with osteoporosis. The data suggest different effects of PTH on bone depending on the baseline skeletal structure, skeletal dynamics, compartments, and menopausal status. © 2018 American Society for Bone and Mineral Research.


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