Tekin Nilgun Solak, Ozdolap Senay, Sarikaya Selda, Keskin Selda Isik
Department of Dermatology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
Int J Dermatol. 2008 Jun;47(6):622-5. doi: 10.1111/j.1365-4632.2008.03534.x.
High-dose isotretinoin has been reported to have adverse effects on bone mineral density (BMD); however, studies evaluating changes in BMD with isotretinoin therapy at different dosages and with varying treatment durations have produced conflicting results.
To investigate the effect of a standard, single course of isotretinoin therapy on BMD and bone turnover markers in patients with nodulocystic acne.
Thirty-six patients (15 male, 21 female) with severe, recalcitrant, nodulocystic acne and 36 healthy controls (16 male, 20 female) were enrolled in the study. Patients received isotretinoin treatment for 4-6 months until a cumulative dose of 120 mg/kg had been achieved. BMD in the lumbar spine and femur was measured at baseline and at the end of therapy by dual-energy X-ray absorptiometry. Serum calcium, phosphate, parathormone, total alkaline phosphatase, osteocalcin, free deoxypyridinoline, and urinary calcium were also measured before and at the end of treatment.
No significant differences were found in lumbar spine and femoral BMD between the patient and control groups at the beginning of the study (P > 0.05), and no statistically significant difference was observed between the BMD values in patients at the beginning vs. the end of treatment (P > 0.05). No statistically significant difference in bone turnover markers was found between patients and controls at the beginning of the study (P > 0.05), and no statistically significant changes in bone turnover markers were observed in patients at the beginning vs. the end of treatment (P > 0.05).
A single course of isotretinoin therapy has no clinically significant effect on bone metabolism.
据报道，高剂量异维A酸对骨矿物质密度（BMD）有不良影响；然而，评估不同剂量和不同治疗持续时间的异维A酸治疗对BMD变化的研究结果相互矛盾。
研究标准单疗程异维A酸治疗对结节囊肿性痤疮患者BMD和骨转换标志物的影响。
36例重度、顽固性结节囊肿性痤疮患者（男15例，女21例）和36例健康对照者（男16例，女20例）纳入本研究。患者接受异维A酸治疗4 - 6个月，直至累积剂量达到120 mg/kg。在基线和治疗结束时通过双能X线吸收法测量腰椎和股骨的BMD。在治疗前和治疗结束时还测量了血清钙、磷、甲状旁腺激素、总碱性磷酸酶、骨钙素、游离脱氧吡啶啉和尿钙。
研究开始时，患者组和对照组的腰椎和股骨BMD无显著差异（P>0.05），治疗开始与结束时患者的BMD值也无统计学显著差异（P>0.05）。研究开始时患者与对照组的骨转换标志物无统计学显著差异（P>0.05），治疗开始与结束时患者的骨转换标志物也无统计学显著变化（P>0.05）。
单疗程异维A酸治疗对骨代谢无临床显著影响。
