Department of Internal Medicine, University of Messina, A.O.U. Policlinico G. Martino Via C. Valeria, 98125, Messina, Italy.
Osteoporos Int. 2011 Jan;22(1):299-303. doi: 10.1007/s00198-010-1222-5. Epub 2010 Mar 23.
The aim of our study was to investigate the effects of teriparatide on the hypophysis-adrenal axis in postmenopausal women. Treatment with teriparatide increased plasmatic and urinary levels of cortisol after 6 and 12 months. Our paper demonstrates a possible direct secretagogue effect of teriparatide on adrenals in osteoporotic postmenopausal women.
Teriparatide, recombinant human parathyroid hormone (1-34) (rhPTH [1-34]), is approved for the treatment of osteoporosis in men and postmenopausal women at high risk for fracture. In literature, data regarding the secretagogue effect of PTH on adrenocortical cells are present on in vitro, but not on in vivo, studies. The aim of our study was to investigate the effects of teriparatide on the hypophysis-adrenal axis in postmenopausal women.
Twenty postmenopausal women with severe osteoporosis were treated with teriparatide in a regimen of 20 μg daily, self-administered injections at bedtime for 12 months and a calcium and vitamin D supplementation. At the same time, 20 osteopenic women matched for age and body mass index with the patients were enrolled and treated only with calcium and vitamin D. In all subjects, calcium, adrenocorticotropic hormone (ACTH), and plasmatic and urinary cortisol were evaluated at baseline and after 6 and 12 months.
Treatment with teriparatide increased plasmatic and urinary levels of cortisol after 6 and 12 months, reaching statistical significance only after 1 year. Plasmatic levels of ACTH did not change significantly.
Our paper, for the first time, demonstrates a possible direct secretagogue effect of teriparatide on adrenals in osteoporotic postmenopausal women.
本研究旨在探讨特立帕肽对绝经后妇女垂体-肾上腺轴的影响。结果：特立帕肽治疗 6 个月和 12 个月后，皮质醇的血浆和尿液水平均升高。我们的论文首次证明了特立帕肽对骨质疏松绝经后妇女肾上腺的直接促分泌作用。简介：特立帕肽，重组人甲状旁腺激素（1-34）（rhPTH [1-34]），获批用于男性和高骨折风险的绝经后妇女骨质疏松症的治疗。文献中，关于 PTH 对肾上腺皮质细胞的促分泌作用的数据存在于体外研究，但不存在于体内研究中。我们的研究目的是探讨特立帕肽对绝经后妇女垂体-肾上腺轴的影响。方法：20 例严重骨质疏松的绝经后妇女接受特立帕肽治疗，方案为每日 20 μg，睡前自我皮下注射，持续 12 个月，并补充钙和维生素 D。同时，招募了 20 名年龄和体重指数与患者匹配的骨质疏松妇女，仅接受钙和维生素 D 治疗。所有受试者在基线时以及治疗 6 个月和 12 个月时评估血钙、促肾上腺皮质激素（ACTH）以及血浆和尿液皮质醇水平。结果：特立帕肽治疗 6 个月和 12 个月后，皮质醇的血浆和尿液水平均升高，仅在 1 年后达到统计学意义。ACTH 的血浆水平无显著变化。结论：我们的论文首次证明了特立帕肽对骨质疏松绝经后妇女肾上腺的直接促分泌作用。
