Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.
J Bone Miner Metab. 2010 May;28(3):334-41. doi: 10.1007/s00774-009-0138-7. Epub 2009 Nov 25.
Dual-energy X-ray absorptiometry-based hip structural analysis was performed to evaluate the effect of a bisphosphonate, minodronic acid hydrate, on the geometry of the proximal femur in Japanese patients with osteoporosis. The subjects were 103 postmenopausal patients (average age 63.9 +/- 6.4 years) with primary osteoporosis. Minodronic acid hydrate was administered orally at a dose of 1 mg/day for 12 months. Significant early responses at 3-6 months after the start of administration were observed in all three regions of the proximal femur (narrow neck, intertrochanter, and shaft) in terms of bone density, geometry, and bone strength indices. The outcomes of therapy included a reduction of the internal diameter of the cortical bone (-0.1, -0.6, and -0.2% in the neck, intertrochanter, and shaft, respectively, at 12 months; not significant) and a significant increase in cortical thickness (3.1, 3.7, and 2.0% in the respective regions at 12 months). Furthermore, minodronic acid hydrate induced a significant enlargement of the cross-sectional bone area, which is related to compressive strength; a significant increase in cross-sectional moment of inertia and section modulus (SM 4.9, 5.8, and 2.9% in the neck, intertrochanter, and shaft, respectively, at 12 months; P < 0.001), which are related to the bending strength; and a significant reduction in buckling ratio (BR -3.0% (P < 0.001), -4.2% (P < 0.001), and -1.4% (P < 0.05) in the respective regions at 12 months), which reflects improved cortical stability. These findings show that minodronic acid hydrate reduces age-related endocortical bone resorption, leading to increased cortical thickness and sustained or enhanced bone strength.
采用双能 X 射线吸收法进行髋关节结构分析，以评估双膦酸盐米诺膦酸水合物对日本骨质疏松症患者股骨近端几何结构的影响。研究对象为 103 例绝经后骨质疏松症患者（平均年龄 63.9 ± 6.4 岁）。米诺膦酸水合物口服给药，剂量为 1 毫克/天，疗程 12 个月。在开始治疗后的 3-6 个月，所有三个股骨近端区域（狭窄颈部、转子间区和骨干）的骨密度、几何形状和骨强度指数均观察到早期显著反应。治疗结果包括皮质骨内直径减小（12 个月时颈、转子间和骨干部位分别减少 0.1%、-0.6%和-0.2%；无统计学意义）和皮质厚度显著增加（12 个月时相应区域分别增加 3.1%、3.7%和 2.0%）。此外，米诺膦酸水合物诱导了横截面积的显著增大，这与抗压强度有关；横截面惯性矩和截面模数显著增加（颈、转子间和骨干部位分别增加 4.9%、5.8%和 2.9%；P < 0.001），这与弯曲强度有关；以及翘曲比显著降低（BR-3.0%（P < 0.001）、-4.2%（P < 0.001）和-1.4%（P < 0.05）；12 个月时分别在相应区域），反映了皮质稳定性的提高。这些发现表明，米诺膦酸水合物可减少与年龄相关的内皮质骨吸收，导致皮质厚度增加和骨强度持续或增强。
