Milos Gabriella, Moergeli Hanspeter, Sob Cynthia, Wisler Doris, Wasila Mariusz, Uebelhart Daniel, Frey Diana
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital of Zurich, Culmannstr. 8, 8091, Zurich, Switzerland.
Clinic for Rheumatology, University Hospital, Zurich, Switzerland.
Calcif Tissue Int. 2021 May;108(5):595-604. doi: 10.1007/s00223-020-00791-3. Epub 2021 Jan 8.
The present pilot study investigated the effect of Teriparatide 1-34 rh-PTH (TPT) in young women diagnosed with anorexia nervosa (AN), and markedly compromised Bone Mineral Density (BMD). Patients were included who had (i) very low BMD (defined as Z-Score < - 2.5 or T-Score < - 2.5 if available) in at least one of the assessed localizations (lumbar spine L1-L4, total hip, femoral neck) without any previous fragility fracture; or (ii) low bone mineral density (defined as Z-Score < - 1.5 or T-Score < - 1.5 if available) in at least one of the assessed localizations (lumbar spine L1-L4, total hip, femoral neck) and at least one previous fragility fracture. Ten patients with an age range of 21-33 were recruited and their bone outcome was assessed after 12, 18, and 24 months. After 24 months of TPT treatment, BMD improved by 13.5% in the spine, 5.0% in the femoral neck, and 4.0% in the hip. Radius cortical bone density (- 2.6%) and radius cortical thickness (- 6.4%) decreased significantly, while in tibia there was no significant decrease. Neither in radius nor in tibia a significant change in trabecular bone parameters occurred. During the treatment, the patients' body weight did not increase significantly. Patients did not experience severe adverse events; only mild side effects were observed. Although these results emerged from a single-arm prospective study, it seems that AN patients with a severely compromised bone situation can benefit from TPT. Larger studies are needed to ascertain the effect of this promising substance.
本初步研究调查了特立帕肽1-34重组人甲状旁腺激素（TPT）对诊断为神经性厌食症（AN）且骨矿物质密度（BMD）明显受损的年轻女性的影响。纳入的患者有：（i）在至少一个评估部位（腰椎L1-L4、全髋、股骨颈）的骨密度极低（定义为Z值< -2.5或T值< -2.5，若可获得）且既往无任何脆性骨折；或（ii）在至少一个评估部位（腰椎L1-L4、全髋、股骨颈）的骨矿物质密度低（定义为Z值< -1.5或T值< -1.5，若可获得）且至少有一次既往脆性骨折。招募了10名年龄在21至33岁之间的患者，并在12、18和24个月后评估其骨骼结果。TPT治疗24个月后，脊柱骨密度提高了13.5%，股骨颈提高了5.0%，髋部提高了4.0%。桡骨皮质骨密度（-2.6%）和桡骨皮质厚度（-6.4%）显著降低，而胫骨无显著降低。桡骨和胫骨的小梁骨参数均未发生显著变化。治疗期间，患者体重未显著增加。患者未经历严重不良事件；仅观察到轻微副作用。尽管这些结果来自单臂前瞻性研究，但似乎骨状况严重受损的AN患者可从TPT中获益。需要更大规模的研究来确定这种有前景的物质的效果。
