Charles Salt Centre for Human Metabolism, Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust, Oswestry, Shropshire, UK.
Calcif Tissue Int. 2011 Mar;88(3):223-30. doi: 10.1007/s00223-010-9452-2. Epub 2010 Dec 19.
The aim of this study was to determine whether the bone-resorption response to anastrozole differed according to initial patient age in postmenopausal women with breast cancer in a cross-sectional study. Second-morning void urines were collected for measurement of urinary cross-linked N-telopeptide of type I collagen (uNTx, corrected for creatinine and log-transformed) from postmenopausal women, 99 with breast cancer on anastrozole (ABC), 88 with newly diagnosed breast cancer (NDBC), and 137 community-dwelling healthy control (HC) women. Bone mineral density (BMD) was also measured at the lumbar spine (LS, L2-L4) and the femoral neck (FN) in the ABC group. uNTx (nanomole bone collagen equivalents/millimole creatinine) levels increased with age in HC subjects. In patients <70 years, anastrozole treatment led to a significant increase in uNTx compared with age-related HC subjects (1.74 vs. 1.55, P < 0.005). Patients >70 years showed no such increase compared to HC (1.72 vs. 1.69, nonsignificant); however, NDBC women >70 years had uNTx levels significantly lower than HC women (1.59 vs. 1.69, P < 0.05). There was no difference in uNTx levels above and below the age of 70 years in NDBC women (1.56 vs. 1.59, nonsignificant). ABC women were more likely to have a positive LS BMD z score than age-matched controls. Anastrozole treatment increases bone turnover more in younger postmenopausal women with breast cancer than in older women compared to healthy controls. Higher LS BMD in ABC patients may help protect against fracture.
本研究旨在通过横断面研究确定在接受阿那曲唑治疗的绝经后乳腺癌女性中，破骨细胞反应是否因初始患者年龄而异。收集绝经后女性的晨尿，测量尿型胶原交联 N 末端肽（uNTx，经肌酐校正并对数转换），包括 99 例接受阿那曲唑治疗的乳腺癌患者（ABC 组）、88 例新诊断乳腺癌患者（NDBC 组）和 137 例社区健康对照（HC 组）。还在 ABC 组中测量腰椎（L2-L4）和股骨颈（FN）的骨密度（BMD）。HC 受试者的 uNTx（纳米摩尔骨胶原当量/毫摩尔肌酐）水平随年龄增加而增加。在<70 岁的患者中，与年龄相关的 HC 受试者相比，阿那曲唑治疗导致 uNTx 显著增加（1.74 比 1.55，P<0.005）。>70 岁的患者与 HC 相比没有这种增加（1.72 比 1.69，无统计学意义）；然而，>70 岁的 NDBC 女性的 uNTx 水平明显低于 HC 女性（1.59 比 1.69，P<0.05）。NDBC 女性在>70 岁和<70 岁之间的 uNTx 水平无差异（1.56 比 1.59，无统计学意义）。ABC 女性的腰椎 BMD z 评分阳性率高于年龄匹配的对照组。与健康对照组相比，阿那曲唑治疗在年轻的绝经后乳腺癌女性中引起的骨转换增加更多，而在老年女性中则较少。ABC 患者的腰椎 BMD 较高可能有助于预防骨折。
