Nakamura Yukio, Suzuki Takako, Kato Hiroyuki
Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan.
Ther Clin Risk Manag. 2017 Oct 9;13:1343-1348. doi: 10.2147/TCRM.S142828. eCollection 2017.
A worldwide health concern, osteoporosis (OP), increases the risk of bone fracture and results in morbidity. This study examined whether the representative bone absorption marker serum tartrate-resistant acid phosphatase 5b (TRACP-5b) or bone formation marker bone alkaline phosphatase (BAP) could estimate primary OP status and denosumab efficacy in a real-world setting. We retrospectively enrolled 114 female postmenopausal primary OP patients in Japan. Values and percent changes in TRACP-5b, BAP, lumbar 1-4 bone mineral density (L-BMD), and total hip BMD (H-BMD) were assessed before treatment and at 4, 8, and 12 months of therapy to identify the correlations between the percent changes in bone metabolic markers and BMD. We also established two sets of subgroups based on the upper limits of reference values in Japan for serum: TRACP-5b (<420 mU/dL) and (≥420 mU/dL) and BAP (<14.5 µg/L) and (≥14.5 µg/L). Negative correlations were observed for the percent changes of TRACP-5b and H-BMD at 4 months (=-0.3476) and 8 months (=-0.3880), for the percent changes of BAP and H-BMD at 8 months (=-0.3354), and for the percent changes of BAP and L-BMD at 12 months (=-0.3186). We observed a significant difference between the subgroups for the percent changes of L-BMD at 8 months (=0.013) and 12 months (=0.004) in BAP values. These results suggest that TRACP-5b and BAP had negative correlations with BMD, and that BAP represented a useful serum marker to evaluate L-BMD during denosumab therapy for OP.
骨质疏松症（OP）是一个全球性的健康问题，它会增加骨折风险并导致发病。本研究探讨了代表性的骨吸收标志物血清抗酒石酸酸性磷酸酶5b（TRACP-5b）或骨形成标志物骨碱性磷酸酶（BAP）是否能够在实际临床环境中评估原发性OP的状况以及地诺单抗的疗效。我们回顾性纳入了日本114名绝经后原发性OP女性患者。在治疗前以及治疗4、8和12个月时评估TRACP-5b、BAP、腰椎1-4骨密度（L-BMD）和全髋骨密度（H-BMD）的值及百分比变化，以确定骨代谢标志物百分比变化与BMD之间的相关性。我们还根据日本血清参考值上限建立了两组亚组：TRACP-5b（<420 mU/dL）和（≥420 mU/dL）以及BAP（<14.5 μg/L）和（≥14.5 μg/L）。在4个月时TRACP-5b百分比变化与H-BMD之间（=-0.3476）以及8个月时（=-0.3880）观察到负相关，8个月时BAP百分比变化与H-BMD之间（=-0.3354）以及12个月时BAP百分比变化与L-BMD之间（=-0.3186）观察到负相关。我们观察到在8个月时（=0.013）和12个月时（=0.004）BAP值的L-BMD百分比变化在亚组之间存在显著差异。这些结果表明，TRACP-5b和BAP与BMD呈负相关，并且BAP是评估OP患者地诺单抗治疗期间L-BMD的有用血清标志物。
