Naruse K, Uchida K, Suto M, Miyagawa K, Kawata A, Urabe K, Takaso M, Itoman M, Mikuni-Takagaki Y
Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374, Japan.
Suto Orthopedic Clinic, Katagama, Japan.
J Bone Miner Metab. 2016 Nov;34(6):615-626. doi: 10.1007/s00774-015-0714-y. Epub 2015 Oct 16.
The lack of estrogen and inactivity are both important in the pathogenesis of osteoporosis in elderly women, and there have been no appropriate rodent studies to examine the effects of common bisphosphonates on these two components separately. We compared the efficacy of alendronate (ALN) on the long bones of aged female rats, which were sedentary, estrogen deficient, or both. The rats were either forced to remain in a sitting position or allowed to walk in standard cages with or without ALN administration. The 8-week experimental period began 5 weeks after ovariectomy or sham surgery. Parameters of the hindlimb bones were determined by a three-point bending test, peripheral quantitative computed tomography, microfocus computed tomography, confocal laser Raman microspectroscopy, and dynamic histomorphometry. Regardless of ovariectomy, ALN was ineffective against the deterioration of breaking stress caused by sitting even though the trabecular bone mineral density was significantly higher in the sitting-ALN groups. Toughness was significantly deficient in the ovariectomy sitting-ALN group. This was in agreement with the bone geometry with a greater marrow space. Sitting also increased the mineral-to-matrix ratio and the carbonate-to-phosphate ratio, both indicative of aged bone. A greater loss of proteinaceous amide intensity compared with mineral intensity resulted in an increased mineral-to-matrix ratio in the presence of ALN. Sitting resulted in deficits in the quality and the geometry of cortical bone, resulting in fragility. The use of bisphosphonates, such as ALN, may provide a therapy best suited for osteoporotic individuals whose daily activity is not limited.
雌激素缺乏和缺乏运动在老年女性骨质疏松症的发病机制中都很重要,而且目前尚无合适的啮齿动物研究分别考察常见双膦酸盐对这两个因素的影响。我们比较了阿仑膦酸钠(ALN)对久坐、雌激素缺乏或两者兼有的老年雌性大鼠长骨的疗效。将大鼠强制保持坐姿或置于标准笼中自由活动,并分别给予或不给予ALN。8周的实验期在卵巢切除或假手术后5周开始。通过三点弯曲试验、外周定量计算机断层扫描、微焦点计算机断层扫描、共聚焦激光拉曼显微光谱和动态组织形态计量学来测定后肢骨骼的参数。无论是否进行卵巢切除术,尽管久坐-ALN组的小梁骨矿物质密度显著更高,但ALN对因久坐引起的断裂应力恶化无效。卵巢切除久坐-ALN组的韧性明显不足。这与骨髓腔较大的骨骼几何形态一致。久坐还会增加矿物质与基质的比例以及碳酸盐与磷酸盐的比例,这两者均表明骨骼老化。与矿物质强度相比,蛋白质酰胺强度的更大损失导致在使用ALN的情况下矿物质与基质的比例增加。久坐会导致皮质骨质量和几何形态出现缺陷,从而导致骨骼脆弱。使用双膦酸盐,如ALN,可能为日常活动不受限的骨质疏松症患者提供最适合的治疗方法。