Kim Sungjun, Bang Hyun Hee, Yoo Hanna, Park Il Hyung, Yang Kyu Hyun, Lim Hyunsun, Jung Woo Seok
Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Biomedical Science, School of Medicine, Kyungpook National University, Daegu, Korea.
J Bone Metab. 2016 May;23(2):85-93. doi: 10.11005/jbm.2016.23.2.85. Epub 2016 May 31.
To retrospectively assess whether the response of subtrochanteric lateral cortex (STLC) is different according to the bisphosphonate agents in terms of bone mineral density (BMD) change.
A total of 149 subjects, who had 2- to 4-year interval follow-up of BMD using dual energy X-ray absorptiometry (DXA), were included in this retrospective study divided into following 3 groups: control group (no consumption of any anti-osteoporotic drugs, n=38), alendronate group (naïve alendronate users, n=48), risedronate group (naïve risedronate users, n=63). BMD was measured at the STLC and subtrochanteric medial cortex (STMC) in each patient by drawing rectangular ROIs at the bone cortices. The percent change of BMD at the STLC were compared between the aforementioned 3 groups by using analysis of covariance model to control five independent variables of age, body mass index, percent change of STMC, hip axis length, time interval between DXA examinations.
The least square mean values±standard deviation of the percent change of BMD in the control, alendronate, and risedronate groups were 1.46±1.50, 2.23±1.26, and 6.96±1.11, respectively. The risedronate group showed significantly higher change of BMD percentage compared with the control (adjusted P=0.012) or alendronate (adjusted P=0.016) groups.
The percent change of BMD at the STLC in the risedronate user group was greater than the alendronate and control groups. The implication of these changes needs to be further verified.
回顾性评估在骨密度(BMD)变化方面,转子下外侧皮质(STLC)对不同双膦酸盐药物的反应是否存在差异。
本回顾性研究纳入了149名受试者,这些受试者使用双能X线吸收法(DXA)进行了2至4年的BMD随访,并分为以下3组:对照组(未服用任何抗骨质疏松药物,n = 38)、阿仑膦酸钠组(初治阿仑膦酸钠使用者,n = 48)、利塞膦酸钠组(初治利塞膦酸钠使用者,n = 63)。通过在骨皮质绘制矩形感兴趣区(ROI),测量每位患者STLC和转子下内侧皮质(STMC)的BMD。使用协方差分析模型控制年龄、体重指数、STMC变化百分比、髋轴长度、DXA检查时间间隔这五个自变量,比较上述3组中STLC的BMD变化百分比。
对照组、阿仑膦酸钠组和利塞膦酸钠组BMD变化百分比的最小二乘均值±标准差分别为1.46±1.50、2.23±1.26和6.96±1.11。与对照组(校正P = 0.012)或阿仑膦酸钠组(校正P = 0.016)相比,利塞膦酸钠组的BMD百分比变化显著更高。
利塞膦酸钠使用者组中STLC的BMD变化百分比大于阿仑膦酸钠组和对照组。这些变化的意义需要进一步验证。