Qin Ling, Choy Wingyee, Au Szeki, Fan Musei, Leung Pingchung
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Orthop Surg Res. 2007 May 21;2:9. doi: 10.1186/1749-799X-2-9.
To identify high-risk patients and provide pharmacological treatment is one of the effective approaches in prevention of osteoporotic fractures. This study investigated the effect of 12-month Alendronate treatment on bone mineral density (BMD) and bone turnover biochemical markers in postmenopausal women with one or more non-traumatic fractures, i.e. patients with established osteoporosis.
A total of 118 Hong Kong postmenopausal Chinese women aged 50 to 75 with low-energy fracture at distal radius (Colles' fracture) were recruited for BMD measurement at lumbar spine and non-dominant hip using Dual-Energy X-ray Absorptiometry (DXA). 47 women with BMD T-score below -2 SD at either side were identified as patients with established osteoporosis and then randomized into Alendronate group (n = 22) and placebo control group (n = 25) for BMD measurement at spine and hip using DXA and distal radius of the non-fracture side by peripheral quantitative computed tomography (pQCT), and bone turnover markers, including bone forming alkaline phosphatase (BALP) and bone resorbing urinary Deoxypyridinoline (DPD). All measurements were repeated at 6 and 12 months.
Alendronate treatment significantly increased BMD, more in weight-bearing skeletons (5.1% at spine and 2.5% at hip) than in non-weight bearing skeleton (0.9% at distal radius) after 12 months treatment. Spine T-score was significant improved in Alendronate group (p < 0.01) (from -2.2 to -1.9) but not in control placebo group. The Alendronate treatment effect was explained by significant suppression of bone turnover.
12 months Alendronate treatment was effective to increase BMD at both axial and appendicular skeletons in postmenopausal women with established osteoporosis.
识别高危患者并给予药物治疗是预防骨质疏松性骨折的有效方法之一。本研究调查了阿仑膦酸钠治疗12个月对有一处或多处非创伤性骨折的绝经后女性（即已确诊骨质疏松症的患者）骨密度（BMD）和骨转换生化标志物的影响。
共招募了118名年龄在50至75岁之间、发生低能量桡骨远端骨折（科雷氏骨折）的香港绝经后中国女性，采用双能X线吸收法（DXA）测量腰椎和非优势髋部的骨密度。47名在任一侧骨密度T值低于-2标准差的女性被确定为已确诊骨质疏松症的患者，然后随机分为阿仑膦酸钠组（n = 22）和安慰剂对照组（n = 25），使用DXA测量脊柱和髋部的骨密度，并通过外周定量计算机断层扫描（pQCT）测量非骨折侧桡骨远端的骨密度，以及测量骨转换标志物，包括骨形成碱性磷酸酶（BALP）和骨吸收指标尿脱氧吡啶啉（DPD）。所有测量在6个月和12个月时重复进行。
阿仑膦酸钠治疗12个月后显著增加了骨密度，负重骨骼（脊柱增加5.1%，髋部增加2.5%）比非负重骨骼（桡骨远端增加0.9%）增加更多。阿仑膦酸钠组的脊柱T值显著改善（p < 0.01）（从-2.2提高到-1.9），而安慰剂对照组则无改善。阿仑膦酸钠的治疗效果是通过显著抑制骨转换来解释的。
阿仑膦酸钠治疗12个月对已确诊骨质疏松症的绝经后女性的轴向和附属骨骼的骨密度增加均有效。
