Department of Internal Medicine, Shimane University, Izumo, Japan.
Am J Med Sci. 2010 Jun;339(6):519-24. doi: 10.1097/MAJ.0b013e3181db6dfe.
Accumulating evidence suggests that osteoporosis and cardiovascular disease have epidemiologic similarities. This study investigated the effects of treatment with risedronate and alfacalcidol on parameters of atherosclerosis in postmenopausal women with type 2 diabetes accompanied with osteoporosis.
Thirteen Japanese type 2 diabetes postmenopausal women with newly diagnosed osteoporosis (osteoporosis group) and 13 age- and weight-matched diabetic women with normal bone mineral density (control group) were enrolled in this 1-year prospective study. Risedronate (2.5 mg/d) and alfacalcidol (1 microg/d) were given to the osteoporosis group for a year. We measured parameters of atherosclerosis, such as ultrasonographically evaluated plaque score (PS) and abdominal aortic calcification score (AACS) calibrated by x-ray.
Patients with osteoporosis had significantly higher PS and AACS than control [mean (range)-PS: 11.85 (0.00-27.50) versus 4.90 (0.00-10.90), P = 0.02 and AACS: 4.0 (0.0-14.0) versus 1.0 (0.0-7.0), P = 0.01]. After 1-year treatment, PS and AACS in the osteoporosis group were not statistically changed, whereas both parameters in the control group were significantly increased (P = 0.01 and P = 0.03, respectively). When percent changes in these parameters were compared between 2 groups, they were significantly different at any time points (at least P < 0.05).
Atherosclerosis parameters in diabetic patients with osteoporosis were higher than those in patients without it. Combination therapy of risedronate with alfacalcidol might protect against progressive atherosclerosis.
越来越多的证据表明,骨质疏松症和心血管疾病具有流行病学相似性。本研究调查了利塞膦酸钠和阿法骨化醇治疗对伴有骨质疏松症的 2 型糖尿病绝经后妇女动脉粥样硬化参数的影响。
本研究纳入了 13 例新诊断为骨质疏松症的日本 2 型糖尿病绝经后妇女(骨质疏松组)和 13 例年龄和体重匹配的骨密度正常的糖尿病妇女(对照组),这些患者参与了一项为期 1 年的前瞻性研究。骨质疏松组患者接受利塞膦酸钠(2.5mg/d)和阿法骨化醇(1μg/d)治疗 1 年。我们通过超声评估斑块评分(PS)和 X 线校准的腹主动脉钙化评分(AACS)来测量动脉粥样硬化参数。
骨质疏松组患者的 PS 和 AACS 显著高于对照组[平均(范围)-PS:11.85(0.00-27.50)与 4.90(0.00-10.90),P=0.02 和 AACS:4.0(0.0-14.0)与 1.0(0.0-7.0),P=0.01]。治疗 1 年后,骨质疏松组的 PS 和 AACS 无统计学变化,而对照组的这两个参数均显著增加(P=0.01 和 P=0.03)。当比较两组间这些参数的百分比变化时,任何时间点的差异均有统计学意义(至少 P<0.05)。
患有骨质疏松症的 2 型糖尿病患者的动脉粥样硬化参数高于无骨质疏松症的患者。利塞膦酸钠联合阿法骨化醇治疗可能有助于预防动脉粥样硬化的进展。