Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Kobe J Med Sci. 2023 Apr 17;69(1):E9-E15.
Few studies on glucocorticoid (GC)-induced osteoporosis exist in IgA nephropathy (IgAN). Here we aimed to compare the effects of bisphosphonate (Bis) and active vitamin D analog (Vit. D) in maintaining bone mineral density (BMD) in patients with IgAN. This study is a retrospective observational one. Between April 2007 and December 2014, a total of 127 patients with IgAN received GC treatment at Kobe University Hospital. Among them, we measured the BMD of 48 patients with a mean age of approximately 30 years, before and after GC treatment. The %ΔBMD of the lumber spine increased in the Bis group (1.6% ± 2.3%), but decreased in the Vit. D group (-3.3% ± 3.6%). The %ΔBMD of the two groups differed significantly (p < 0.05). Although the %ΔBMD of the femoral neck showed the same tendency, the difference between two groups was not significant. Bis was significantly superior to Vit. D in maintaining the BMD of lumbar spine bones. Even in young patients with IgAN, Bis is recommended to prevent the reduction of BMD during GC treatment.
在 IgA 肾病 (IgAN) 中，关于糖皮质激素 (GC) 诱导性骨质疏松症的研究较少。本研究旨在比较双膦酸盐 (Bis) 和活性维生素 D 类似物 (Vit. D) 在维持 IgAN 患者骨密度 (BMD) 方面的作用。这是一项回顾性观察性研究。2007 年 4 月至 2014 年 12 月，神户大学医院共收治 127 例接受 GC 治疗的 IgAN 患者。其中，我们测量了 48 例平均年龄约为 30 岁的患者在 GC 治疗前后的 BMD。腰椎骨的 %ΔBMD 在 Bis 组中增加（1.6%±2.3%），但在 Vit. D 组中减少（-3.3%±3.6%）。两组之间的 %ΔBMD 差异有统计学意义（p<0.05）。虽然股骨颈的 %ΔBMD 也有相同的趋势，但两组之间的差异没有统计学意义。Bis 在维持腰椎骨 BMD 方面明显优于 Vit. D。即使是年轻的 IgAN 患者，也建议使用 Bis 预防 GC 治疗期间 BMD 的减少。
