Takakuwa M, Otsuka K, Konishi M, Itabashi K
Takakuwa Orthopaedic Nagayama Clinic, Asahikawa City, Hokkaido, Japan.
J Int Med Res. 2009 Nov-Dec;37(6):1972-81. doi: 10.1177/147323000903700635.
The effect of risedronate (2.5 mg once daily) on femoral strength was evaluated using Advanced Hip Assessment (AHA) for the first time in Japan. In total, 104 patients with primary osteoporosis and available data on bone mineral density (BMD; lumbar spine/proximal femur), urinary NTx (cross-linked N-telopeptides of type I collagen) and AHA-based parameters collected before and after 4 months of risedronate therapy were included in the analyses. Change and percentage change from baseline in these parameters were determined. Percentage change in femur strength index was 7.9 +/- 21.1% and 5.5 +/- 18.0% for the right and left femurs, respectively; both increases were statistically significant. Cross-sectional moment of inertia, cross-sectional area and mean neck width in the femoral neck region of interest also increased significantly in both femurs. Percentage change in lumbar spine BMD (L2 - L4) was 3.0 +/- 3.7%, and proximal femoral BMD was 1.1 +/- 3.1% and 0.7 +/- 3.2% in the right and left femurs, respectively, all showing a significant increase from baseline. Percentage change in urinary NTx was -41.5 +/- 30.5%, which was a significant decrease. Using AHA, this study showed that, in patients with primary osteoporosis, risedronate improved BMD and bone quality, thereby enhancing femoral strength as early as 4 months after treatment initiation.
在日本首次使用高级髋部评估(AHA)评估了利塞膦酸盐(每日一次,2.5毫克)对股骨强度的影响。总共104例原发性骨质疏松症患者纳入分析,这些患者有骨矿物质密度(BMD;腰椎/股骨近端)、尿NTx(I型胶原交联N-端肽)以及利塞膦酸盐治疗4个月前后收集的基于AHA的参数的可用数据。确定了这些参数相对于基线的变化和变化百分比。右股骨和左股骨的股骨强度指数变化百分比分别为7.9±21.1%和5.5±18.0%;两者的增加均具有统计学意义。感兴趣的股骨颈区域的截面惯性矩、截面积和平均颈宽在两侧股骨中也显著增加。腰椎BMD(L2 - L4)的变化百分比为3.0±3.7%,右股骨和左股骨近端股骨BMD分别为1.1±3.1%和0.7±3.2%,均显示相对于基线有显著增加。尿NTx的变化百分比为-41.5±30.5%,这是显著下降。本研究使用AHA表明,在原发性骨质疏松症患者中,利塞膦酸盐可改善BMD和骨质,从而在治疗开始后4个月就增强股骨强度。