Niimi Rui, Kono Toshibumi, Nishihara Atsushi, Hasegawa Masahiro, Matsumine Akihiko, Kono Toshihiko, Sudo Akihiro
Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahama-cho, Yokkaichi-city, Mie 510-8008, Japan.
Department of Orthopaedic Surgery, Mie University, Graduate School of Medicine, 2-174, Edobashi, Tsu-city, Mie 514-8507, Japan.
Bone. 2014 Sep;66:26-30. doi: 10.1016/j.bone.2014.05.017. Epub 2014 Jun 5.
Several factors associated with bone mineral density (BMD) increase are reported with daily teriparatide treatment, but there has been no systematic analysis to summarize these associations. The purpose of this study was to investigate the clinical determinants associated with BMD increase to daily teriparatide treatment.
This was a retrospective study. We performed an analysis of 306 patients diagnosed with osteoporosis. Teriparatide was administered at 20μg/day for 12months. The primary efficacy measure was a change in lumbar spine (LS) BMD from baseline at 12months. To determine the response variables of BMD changes, we investigated the clinical determinants using univariate and multivariate analyses.
There was a 9.8±8.2% increase in LS BMD after 12months. Prior bisphosphonate treatment and baseline procollagen type I N-terminal propeptide (PINP) concentration were significantly associated with LS BMD absolute response by univariate analyses. In the multiple regression model, patients with higher baseline PINP concentration had a significantly greater LS BMD absolute increase. Prior bisphosphonate use lost its correlation in the multiple regression models.
Our results showed that baseline PINP concentration was a useful predictor of LS BMD absolute increase regardless of prior treatment.
每日使用特立帕肽治疗时，有多种与骨密度（BMD）增加相关的因素被报道，但尚未有系统分析来总结这些关联。本研究的目的是调查每日使用特立帕肽治疗时与BMD增加相关的临床决定因素。
这是一项回顾性研究。我们对306例诊断为骨质疏松症的患者进行了分析。特立帕肽以每日20μg的剂量给药，持续12个月。主要疗效指标是12个月时腰椎（LS）骨密度相对于基线的变化。为了确定骨密度变化的反应变量，我们使用单变量和多变量分析研究了临床决定因素。
12个月后，腰椎骨密度增加了9.8±8.2%。单变量分析显示，既往双膦酸盐治疗和基线I型前胶原N端前肽（PINP）浓度与腰椎骨密度的绝对反应显著相关。在多元回归模型中，基线PINP浓度较高的患者腰椎骨密度的绝对增加显著更大。在多元回归模型中，既往使用双膦酸盐失去了相关性。
我们的结果表明，无论既往治疗情况如何，基线PINP浓度都是腰椎骨密度绝对增加的有用预测指标。
