Department of Endocrinology, Ippokration General Hospital, Thessaloniki, Greece.
J Clin Densitom. 2010 Apr-Jun;13(2):190-6. doi: 10.1016/j.jocd.2010.01.006. Epub 2010 Mar 27.
The main aim of this study was to determine the effect of zoledronic acid (ZOL) on parameters of dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) in unaffected bones of patients with Paget's disease of bone (PDB). The secondary aim was the association of bone markers and Dickkopf (DKK)-1 with parameters of DXA and QUS. Ten consecutive patients with polyostotic PDB (median age: 63 yr) received a single 5-mg ZOL infusion. The patients were subjected to calcaneal QUS and DXA of both lumbar spine (LS) and femoral neck (FN). Blood samples for serum bone markers and DKK-1 were serially obtained for 12 mo. There was a significant increase in LS (p=0.005) and FN bone mineral density (BMD) (p=0.021) 12 mo after ZOL infusion. QUS parameters remained unaffected throughout the study. A significant correlation between broadband ultrasound attenuation and DKK-1 (p<0.001) and between speed of sound and DKK-1 (p=0.033) at baseline was found, which remained significant after adjustment for gender, age, and body mass index. Our data suggest that a single ZOL infusion significantly increases nonpagetic BMD 12 mo after treatment but has no effect on QUS parameters or DKK-1. Significant correlations were observed between QUS parameters and DKK-1 at baseline.
本研究的主要目的是确定唑来膦酸（zoledronic acid，ZOL）对骨 Pagetic 病（PDB）患者未受影响骨骼的双能 X 射线吸收法（DXA）和定量超声（QUS）参数的影响。次要目的是研究骨标志物和 Dickkopf（DKK）-1与 DXA 和 QUS 参数的相关性。连续纳入 10 例多灶性 PDB 患者（中位年龄：63 岁），接受单次 5mg ZOL 输注。对患者进行跟骨 QUS 和腰椎（LS）及股骨颈（FN）的 DXA 检查。在 12 个月内连续采集血清骨标志物和 DKK-1 血样。ZOL 输注 12 个月后，LS（p=0.005）和 FN 骨密度（BMD）（p=0.021）显著增加。整个研究过程中 QUS 参数均无变化。在基线时发现宽带超声衰减与 DKK-1（p<0.001）和声速与 DKK-1（p=0.033）之间存在显著相关性，调整性别、年龄和体重指数后仍然显著。我们的数据表明，单次 ZOL 输注可显著增加 Pagetic 疾病治疗后 12 个月的非 Pagetic 骨密度，但对 QUS 参数或 DKK-1 无影响。在基线时观察到 QUS 参数与 DKK-1 之间存在显著相关性。
