Bruder Jan M, Ma Jennie Z, Basler Joseph W, Welch Michelle D
Division of Endocrinology, Department of Internal Medicine, University of Texas Health Science Center, San Antonio, Texas 78284-7877, USA.
Urology. 2006 Jan;67(1):152-5. doi: 10.1016/j.urology.2005.07.017.
To determine the prevalence of osteopenia and osteoporosis by central (spine and hip) and peripheral (radius) bone mineral density (BMD) in men with prostate cancer undergoing androgen-deprivation therapy (ADT). Low BMD and fractures are prevalent in this group of men. Most published studies on ADT-related bone loss have documented the loss of BMD in the spine and hip as measured by dual x-ray absorptiometry. In one study, the loss of BMD was most pronounced at the radius.
In a chart review of patients receiving ADT, the spine and hip BMD results were recorded in 89 patients. Of these 89 patients, the BMD of the radius was also recorded in 53.
In the 89 patients with BMD measurements of the spine and hip, 24 (26.9%) had osteoporosis of the hip or spine as defined by a T score of -2.5 or less, and 45 patients (50.6%) had osteopenia (T score -1.0 to -2.5). In the subset of 53 patients who also had the BMD of the radius measured, the results of the BMD of the radius changed the category of diagnosis in 18 patients (34%). The prevalence of osteoporosis increased from 25% to 53% when the results of the radius were included.
Men with prostate cancer treated with ADT have a high prevalence of osteopenia and osteoporosis as determined by peripheral and central BMD measurements. The use of the peripheral BMD measurement appears to identify more patients with osteoporosis and suggests its use in the evaluation of osteoporosis in men receiving ADT.
通过对接受雄激素剥夺治疗(ADT)的前列腺癌男性患者进行中央(脊柱和髋部)及外周(桡骨)骨密度(BMD)检测,以确定骨质减少和骨质疏松的患病率。该组男性中低骨密度和骨折较为普遍。大多数关于ADT相关骨质流失的已发表研究记录了通过双能X线吸收法测量的脊柱和髋部骨密度的降低。在一项研究中,桡骨的骨密度降低最为明显。
在对接受ADT的患者进行病历回顾时,记录了89例患者的脊柱和髋部骨密度结果。在这89例患者中,还记录了53例患者的桡骨骨密度。
在89例进行了脊柱和髋部骨密度测量的患者中,24例(26.9%)髋部或脊柱骨质疏松,定义为T值≤ -2.5,45例患者(50.6%)骨质减少(T值 -1.0至 -2.5)。在53例也测量了桡骨骨密度的患者亚组中,桡骨骨密度结果改变了18例患者(34%)的诊断类别。纳入桡骨结果后,骨质疏松患病率从25%升至53%。
通过外周和中央骨密度测量确定,接受ADT治疗的前列腺癌男性中骨质减少和骨质疏松的患病率很高。外周骨密度测量似乎能识别出更多骨质疏松患者,并建议将其用于评估接受ADT治疗的男性的骨质疏松情况。