Senn C, Günther B, Popp A W, Perrelet R, Hans D, Lippuner K
Department of Osteoporosis, Inselspital, Berne University Hospital and University of Berne, CH-3010, Berne, Switzerland.
Osteoporos Int. 2014 Jul;25(7):1945-51. doi: 10.1007/s00198-014-2703-8. Epub 2014 Apr 24.
Treatment effects over 2 years of teriparatide vs. ibandronate in postmenopausal women with osteoporosis were compared using lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). Teriparatide induced larger increases in BMD and TBS compared to ibandronate, suggesting a more pronounced effect on bone microarchitecture of the bone anabolic drug.
The trabecular bone score (TBS) is an index of bone microarchitecture, independent of bone mineral density (BMD), calculated from anteroposterior spine dual X-ray absorptiometry (DXA) scans. The potential role of TBS for monitoring treatment response with bone-active substances is not established. The aim of this study was to compare the effects of recombinant human 1-34 parathyroid hormone (teriparatide) and the bisphosphonate ibandronate (IBN), on lumbar spine (LS) BMD and TBS in postmenopausal women with osteoporosis.
Two patient groups with matched age, body mass index (BMI), and baseline LS BMD, treated with either daily subcutaneous teriparatide (N = 65) or quarterly intravenous IBN (N = 122) during 2 years and with available LS BMD measurements at baseline and 2 years after treatment initiation were compared.
Baseline characteristics (overall mean ± SD) were similar between groups in terms of age 67.9 ± 7.4 years, body mass index 23.8 ± 3.8 kg/m(2), BMD L1-L4 0.741 ± 0.100 g/cm(2), and TBS 1.208 ± 0.100. Over 24 months, teriparatide induced a significantly larger increase in LS BMD and TBS than IBN (+7.6 % ± 6.3 vs. +2.9 % ± 3.3 and +4.3 % ± 6.6 vs. +0.3 % ± 4.1, respectively; P < 0.0001 for both). LS BMD and TBS were only weakly correlated at baseline (r (2) = 0.04) with no correlation between the changes in BMD and TBS over 24 months.
In postmenopausal women with osteoporosis, a 2-year treatment with teriparatide led to a significantly larger increase in LS BMD and TBS than IBN, suggesting that teriparatide had more pronounced effects on bone microarchitecture than IBN.
使用腰椎骨密度（BMD）和小梁骨评分（TBS）比较了绝经后骨质疏松症女性使用特立帕肽与伊班膦酸钠治疗2年的效果。与伊班膦酸钠相比，特立帕肽使BMD和TBS有更大幅度的增加，表明这种骨合成代谢药物对骨微结构的影响更为显著。
小梁骨评分（TBS）是一种独立于骨密度（BMD）的骨微结构指标，通过脊柱前后位双能X线吸收测定法（DXA）扫描计算得出。TBS在监测骨活性物质治疗反应方面的潜在作用尚未确立。本研究的目的是比较重组人1-34甲状旁腺激素（特立帕肽）和双膦酸盐伊班膦酸钠（IBN）对绝经后骨质疏松症女性腰椎（LS）BMD和TBS的影响。
比较了两组年龄、体重指数（BMI）和基线LS BMD相匹配的患者，一组在2年期间每日皮下注射特立帕肽（N = 65），另一组每季度静脉注射IBN（N = 122），并在基线和治疗开始后2年有可用的LS BMD测量值。
两组的基线特征（总体均值±标准差）相似，年龄为67.9±7.4岁，体重指数为23.8±3.8kg/m²，L1-L4 BMD为0.741±0.100g/cm²，TBS为1.208±0.100。在24个月期间，特立帕肽使LS BMD和TBS的增加显著大于IBN（分别为+7.6%±6.3对+2.9%±3.3以及+4.3%±6.6对+0.3%±4.1；两者P均<0.0001）。基线时LS BMD和TBS仅呈弱相关（r² = 0.04），24个月内BMD和TBS的变化之间无相关性。
在绝经后骨质疏松症女性中，特立帕肽治疗2年导致LS BMD和TBS的增加显著大于IBN，表明特立帕肽对骨微结构的影响比IBN更为显著。
