Tatara Marcin R, Krupski Witold, Majer-Dziedzic Barbara
Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, ul. Akademicka 12 II Department of Radiology, Medical University in Lublin, ul. Staszica 16 Department of Microbiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, ul. Akademicka 12, Lublin, Poland.
Medicine (Baltimore). 2017 Oct;96(41):e8178. doi: 10.1097/MD.0000000000008178.
Currently available approaches to osteoporosis treatment include application of antiresorptive and anabolic agents influencing bone tissue metabolism. The aim of the study was to present bone mineral density (BMD) changes of lumbar spine in osteoporotic patient treated with bisphosphonates such as ibandronic acid and pamidronic acid, and beta-hydroxy-beta-methylbutyrate (HMB).
BMD and volumetric BMD (vBMD) of lumbar spine were measured during the 6 year observation period with the use of dual-energy X-ray absorptiometry (DEXA) and quantitative computed tomography (QCT).
The described case report of osteoporotic patient with family history of severe osteoporosis has shown site-dependent response of bone tissue to antiosteoporotic treatment with bisphosphonates.
Twenty-five-month treatment with ibandronic acid improved proximal femur BMD with relatively poor effects on lumbar spine BMD. Over 15-month therapy with pamidronic acid was effective to improve lumbar spine BMD, while in the proximal femur the treatment was not effective. A total of 61-week long oral administration with calcium salt of HMB improved vBMD of lumbar spine in the trabecular and cortical bone compartments when monitored by QCT. Positive effects of nearly 2.5 year HMB treatment on BMD of lumbar spine and femur in the patient were also confirmed using DEXA method.
The results obtained indicate that HMB may be applied for the effective treatment of osteoporosis in humans. Further studies on wider human population are recommended to evaluate mechanisms influencing bone tissue metabolism by HMB.
目前可用的骨质疏松症治疗方法包括应用影响骨组织代谢的抗吸收和促合成药物。本研究的目的是呈现接受双膦酸盐（如伊班膦酸和帕米膦酸）以及β-羟基-β-甲基丁酸酯（HMB）治疗的骨质疏松症患者腰椎骨矿物质密度（BMD）的变化。
在6年观察期内，使用双能X线吸收法（DEXA）和定量计算机断层扫描（QCT）测量腰椎的BMD和体积骨密度（vBMD）。
所描述的患有严重骨质疏松症家族史的骨质疏松症患者的病例报告显示，骨组织对双膦酸盐抗骨质疏松治疗存在部位依赖性反应。
伊班膦酸25个月的治疗改善了股骨近端的BMD，但对腰椎BMD的影响相对较小。帕米膦酸15个月以上的治疗有效改善了腰椎BMD，而对股骨近端的治疗无效。通过QCT监测，HMB钙盐61周的口服给药改善了腰椎小梁骨和皮质骨区域的vBMD。使用DEXA方法也证实了近2.5年HMB治疗对该患者腰椎和股骨BMD的积极影响。
获得的结果表明，HMB可用于有效治疗人类骨质疏松症。建议对更广泛的人群进行进一步研究，以评估HMB影响骨组织代谢的机制。
