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罗格列酮对绝经后糖尿病女性骨密度和重塑参数的影响:一项为期 2 年的随访研究。

Effects of rosiglitazone on bone mineral density and remodelling parameters in Postmenopausal diabetic women: a 2-year follow-up study.

机构信息

Department of Endocrinology and Metabolism, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.

出版信息

Clin Endocrinol (Oxf). 2010 Sep;73(3):305-12. doi: 10.1111/j.1365-2265.2010.03784.x. Epub 2010 Feb 10.

Abstract

OBJECTIVE

To evaluate the effect of rosiglitazone on bone metabolism and bone density.

DESIGN

An open-label, randomized, controlled trial of 24-month duration. Patients and measurements Obese, postmenopausal women with newly diagnosed diabetes were studied. Before and after the intervention, metabolic bone markers and bone density were assessed.

RESULTS

Twenty-six patients received rosiglitazone (4 mg/day), and 23 remained on diet alone. Serum bone-specific alkaline phosphatase and osteocalcin levels decreased by 17% (P < 0.001 vs control group) and 26% (P < 0.01 vs control group), respectively, in the rosiglitazone group. There were no significant changes in the deoxypyridinoline levels between the two groups. Annual bone loss at the trochanter and at the lumbar spine associated with each year of rosiglitazone use was 2.56% (P = 0.01 vs control group) and 2.18% (P < 0.01 vs control group), respectively. Femoral neck and total hip bone density declined significantly in both groups (P < 0.01, and P = 0.01, respectively) but was not significantly different between the two groups.

CONCLUSIONS

Rosiglitazone treatment adversely affects bone formation over a 2-year period. It increases bone loss at the lumbar spine and trochanter in postmenopausal, type 2 diabetic women. However, bone loss at the total hip did not differ with use of this agent.

摘要

目的

评估罗格列酮对骨代谢和骨密度的影响。

设计

一项为期 24 个月的开放性、随机、对照试验。

患者和测量

研究了新诊断为糖尿病的肥胖绝经后妇女。干预前后评估代谢性骨标志物和骨密度。

结果

26 例患者接受罗格列酮(4 mg/天)治疗,23 例患者单独接受饮食治疗。罗格列酮组血清骨特异性碱性磷酸酶和骨钙素水平分别下降 17%(P<0.001 与对照组相比)和 26%(P<0.01 与对照组相比)。两组脱氧吡啶啉水平均无显著变化。与罗格列酮使用每增加 1 年相关,转子和腰椎的年骨丢失分别为 2.56%(P=0.01 与对照组相比)和 2.18%(P<0.01 与对照组相比)。两组股骨颈和全髋关节骨密度均显著下降(P<0.01,P=0.01,分别),但两组之间无显著差异。

结论

罗格列酮治疗在 2 年内对骨形成产生不利影响。它增加了绝经后 2 型糖尿病妇女腰椎和转子的骨丢失。然而,使用该药物不会导致全髋关节的骨丢失有所不同。

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