Koo Young Ah, Son Kyung A, Choi Suk Joo, Yoon Byung Koo
Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Menopausal Med. 2019 Dec;25(3):117-122. doi: 10.6118/jmm.19198.
We evaluated the effects of adding intravenous pamidronate to ongoing menopausal hormone therapy (MHT) on bone mineral density (BMD) in postmenopausal Korean women with low BMD.
This retrospective cohort study included 74 postmenopausal women who received MHT for at least 1 year and had a BMD T-score of less than -2.0. Maintaining the same MHT regimen, these women were divided into two groups: oral placebo group (n = 44) and a pamidronate group of patients with gastrointestinal discomfort (n = 30) who received 15-30 mg pamidronate intravenously every 3-12 months. BMD was reviewed at 12-month follow-up. Bone resorption markers in both groups, urinary deoxypyridinoline levels in the placebo group, and serum N-telopeptide of type I collagen in the pamidronate group were assessed at 6 and 12 months.
At baseline, the body mass index (BMI), duration of previous MHT, and femur neck (FN) BMD differed between the groups. Within-group analysis revealed that BMD of the lumbar spine (LS) and total hip (TH) significantly increased in the placebo group, whereas those of the LS, FN, and TH increased in the pamidronate group. The increase in BMD of LS was significantly greater in the pamidronate group, after adjusting for BMI and duration of previous MHT (mean change: 3.7% vs. 6.2%; < 0.001). There were no changes in bone resorption markers in either group.
Adding intravenous pamidronate to ongoing MHT for 12 months might increase LS BMD in postmenopausal Korean women with low BMD.
我们评估了在绝经后韩国低骨密度女性正在进行的绝经激素治疗（MHT）基础上加用静脉注射帕米膦酸盐对骨密度（BMD）的影响。
这项回顾性队列研究纳入了74名接受MHT至少1年且骨密度T值小于-2.0的绝经后女性。维持相同的MHT方案，这些女性被分为两组：口服安慰剂组（n = 44）和胃肠道不适的帕米膦酸盐组（n = 30），后者每3 - 12个月静脉注射15 - 30 mg帕米膦酸盐。在12个月随访时复查骨密度。在6个月和12个月时评估两组的骨吸收标志物、安慰剂组的尿脱氧吡啶啉水平以及帕米膦酸盐组的血清I型胶原N端肽水平。
基线时，两组间体重指数（BMI）、既往MHT持续时间和股骨颈（FN）骨密度存在差异。组内分析显示，安慰剂组腰椎（LS）和全髋（TH）骨密度显著增加，而帕米膦酸盐组LS、FN和TH骨密度增加。在调整BMI和既往MHT持续时间后，帕米膦酸盐组LS骨密度的增加显著更大（平均变化：3.7%对6.2%；<0.001）。两组骨吸收标志物均无变化。
在绝经后韩国低骨密度女性正在进行的MHT基础上加用静脉注射帕米膦酸盐12个月可能会增加腰椎骨密度。
