Department of Orthopedic Surgery, Sapporo Medical University, Sapporo, Japan.
J Bone Miner Metab. 2010 Sep;28(5):561-7. doi: 10.1007/s00774-010-0164-5. Epub 2010 Mar 24.
The purpose of this study was to clarify the effects of 2-year treatment with raloxifene on the proximal femoral geometry among Japanese patients with osteoporosis by hip structure analysis. One hundred ninety-eight community-dwelling postmenopausal women with osteoporosis were enrolled. The structural variables were areal bone mineral density (BMD), cross-sectional area (CSA), section modulus (index of resistance to bending forces), and buckling ratio (index of cortical instability). BMD, CSA, and section modulus at the narrow neck significantly increased by 1.27, 2.67, and 3.90% at 2 years, respectively. BMD, CSA, and section modulus at the intertrochanter significantly increased by 2.55, 4.49, and 6.60% at study termination, respectively. The buckling ratio at the intertrochanter decreased by 2.36% at 1 year, but differences at 2 years became non-significant. Parameters at the shaft were qualitatively similar to those of the narrow neck and intertrochanter. The percent change of the section modulus was significantly higher than that of BMD at 2 years in all three regions. The percent changes of the section modulus is strongly correlated with the percent changes of BMD and CSA, and negative correlated with the percent changes of buckling ratio in all regions. In conclusion, Japanese osteoporotic women on raloxifene therapy have significant improvements of both BMD and geometry in the proximal femur.
本研究旨在通过髋关节结构分析明确雷洛昔芬治疗 2 年对日本骨质疏松症患者股骨近端几何结构的影响。共纳入 198 例社区居住的绝经后骨质疏松症女性患者。结构变量包括面积骨密度（BMD）、横截面积（CSA）、截面模数（抗弯曲力指数）和屈曲比（皮质不稳定性指数）。2 年后，窄颈处的 BMD、CSA 和截面模数分别显著增加了 1.27%、2.67%和 3.90%。研究结束时，股骨粗隆间处的 BMD、CSA 和截面模数分别显著增加了 2.55%、4.49%和 6.60%。股骨粗隆间处的屈曲比在 1 年内下降了 2.36%，但 2 年内的差异无统计学意义。轴处的参数与窄颈和股骨粗隆间处的参数定性相似。2 年内，所有三个部位的截面模数的变化百分比均显著高于 BMD 的变化百分比。在所有三个部位，截面模数的变化百分比与 BMD 和 CSA 的变化百分比呈正相关，与屈曲比的变化百分比呈负相关。综上所述，接受雷洛昔芬治疗的日本骨质疏松症女性患者的股骨近端骨密度和几何结构均有显著改善。
