鼻用鲑鱼降钙素可减轻健康绝经后女性的骨微结构改变。
Nasal salmon calcitonin blunts bone microstructure alterations in healthy postmenopausal women.
作者信息
Rizzoli R, Sigaud A, Azria M, Herrmann F R
机构信息
Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland,
出版信息
Osteoporos Int. 2015 Jan;26(1):383-93. doi: 10.1007/s00198-014-2937-5. Epub 2014 Oct 22.
UNLABELLED
In healthy postmenopausal women, nasal salmon calcitonin blunted distal radius and tibia bone microstructure degradation.
INTRODUCTION
Nasal salmon calcitonin (NSC) has been reported to lower vertebral fracture risk by 33%, but to modestly increase spine areal bone mineral density (aBMD) by 1.5%. Thus, NSC may also influence bone microstructure, another known determinant of bone strength.
METHODS
In a randomized, double-blind, placebo-controlled trial, we investigated the effects of 200 IU/day NSC on distal radius and tibia bone microstructure (by high-resolution 3-dimensional peripheral quantitative computerized tomography), aBMD (by dual-energy X-ray absorptiometry), and serum bone turnover markers in healthy postmenopausal women.
RESULTS
Mean age was 57.6 ± 0.8 (±SEM) and 57.4 ± 0.7 in NSC (n = 45) and placebo groups (n = 45), respectively. Mean femoral neck T-score was in the osteopenic range; prevalent vertebral fracture was 4% in each group. There was no observed between-group difference in the primary outcome distal radius BV/TV (-2.8 ± 0.6% vs. -4.3 ± 1.0%, NS). By 2 years, the decrease in distal radius total density vs. baseline was 4.4 ± 0.7% in controls and 2.1 ± 0.6% in NSC-receiving patients (p < 0.05). Distal radius and tibia cortical thickness decreased by 3.7 ± 1.0 and 2.4 ± 0.5% in placebo (p < 0.05 vs. baseline for both), respectively, but not in the NSC group. Distal radius total density and cortical thickness changes were lower in NSC group than in placebo (p < 0.05 for both) in the subgroup with baseline C-terminal telopeptides (CTX) above the median. By 6 and 12 months, serum CTX decreased by 17.3 ± 6.2 and 19.1 ± 6.6% (both p < 0.05 vs. baseline), respectively, in NSC, but remained stable in controls (NS vs. baseline). There was no difference in aBMD. NSC was well tolerated, with less arthralgia than the placebo group (14 vs. 26, p < 0.05).
CONCLUSION
Nasal salmon calcitonin blunted the degradation of distal radius and tibia bone microstructure in healthy postmenopausal women.
未标注
在健康的绝经后女性中，鼻用鲑鱼降钙素可减缓桡骨远端和胫骨骨微结构的退化。
引言
据报道，鼻用鲑鱼降钙素（NSC）可使椎体骨折风险降低33%，但只能使脊柱骨面积密度（aBMD）适度增加1.5%。因此，NSC可能也会影响骨微结构，而骨微结构是另一个已知的骨强度决定因素。
方法
在一项随机、双盲、安慰剂对照试验中，我们研究了每天200 IU的NSC对健康绝经后女性桡骨远端和胫骨骨微结构（通过高分辨率三维外周定量计算机断层扫描）、aBMD（通过双能X线吸收法）以及血清骨转换标志物的影响。
结果
NSC组（n = 45）和安慰剂组（n = 45）的平均年龄分别为57.6±0.8（±SEM）和57.4±0.7。平均股骨颈T值处于骨质减少范围内；每组中椎体骨折的发生率均为4%。在主要结局桡骨远端骨体积分数（BV/TV）方面，未观察到组间差异（-2.8±0.6%对-4.3±1.0%，无统计学意义）。到2年时，对照组桡骨远端总密度相对于基线的下降幅度为4.4±0.7% , 接受NSC治疗的患者为2.1±0.6%（p<0.05）。安慰剂组桡骨远端和胫骨皮质厚度分别下降了3.7±1.0%和2.4±0.5%（两者与基线相比p<0.05），而NSC组未出现下降。在基线C末端肽（CTX）高于中位数的亚组中，NSC组桡骨远端总密度和皮质厚度的变化低于安慰剂组（两者p<0.05）。在NSC组中，到6个月和12个月时，血清CTX分别下降了17.3±6.2%和19.1±6.6%（两者与基线相比p<0.05），而在对照组中保持稳定（与基线相比无统计学意义）。aBMD没有差异。NSC耐受性良好，关节痛比安慰剂组少（14例对26例，p<0.05）。
结论
鼻用鲑鱼降钙素可减缓健康绝经后女性桡骨远端和胫骨骨微结构的退化。
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