Rizzoli R, Chevalley T, Slosman D O, Bonjour J P
Division of Clinical Pathophysiology (World Health Organization Collaborating Center for Osteoporosis and Bone Disease), University Hospital of Geneva, Switzerland.
Osteoporos Int. 1995 Jan;5(1):39-46. doi: 10.1007/BF01623657.
Corticosteroid-induced osteoporosis, which particularly affects the axial skeleton and the proximal femur, is characterized by a state of low bone remodelling. Fluoride is a potent stimulator of trabecular bone formation which could potentially be useful in the treatment of corticosteroid-induced osteoporosis. We investigated the effects of sodium monofluorophosphate (26 mg/day of fluoride) combined with 1000 mg of calcium (MFP-calcium-treated group), or of calcium alone (control), given for 18 months, on bone mineral density (BMD) of lumbar spine (LS), femoral neck (FN) and midfemoral shaft (FS) in 48 patients with corticosteroid-induced osteoporosis. Mean ages were 49.4 +/- 3.1 and 51.6 +/- 3.0 years (mean +/- SEM), duration of corticosteroid therapy 7.5 +/- 1.8 and 9.3 +/- 1.7 years, and mean daily dose of prednisone 18.2 +/- 2.3 and 12.1 +/- 1.1 mg in the MFP-calcium-treated group and controls, respectively. Initial BMDs (expressed as the Z-score, i.e. the difference in standard deviations from age- and sex-matched normal subjects) were -1.5 +/- 0.2 and -1.2 +/- 0.2 for LS, -1.4 +/- 0.2 and -1.3 +/- 0.2 for FN, and -0.8 +/- 0.3 and -0.6 +/- 0.3 for FS, in the MFP-calcium-treated group and controls, respectively. Analysis by linear regression of 6-monthly measurement values revealed BMD changes of +7.8 +/- 2.2 versus +3.6 +/- 1.3% (p < 0.02) for LS, -1.5 +/- 1.8 versus +0.9 +/- 1.8% for FN, and -1.1 +/- 1.1 versus -0.5 +/- 1.4% for FS after 18 months of follow-up in the MFP-calcium-treated group and controls, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
皮质类固醇诱导的骨质疏松症尤其影响中轴骨骼和股骨近端，其特征是骨重塑水平较低。氟化物是小梁骨形成的有效刺激剂，可能对治疗皮质类固醇诱导的骨质疏松症有用。我们研究了单氟磷酸钠（每日26毫克氟化物）联合1000毫克钙（MFP - 钙治疗组）或单独使用钙（对照组），给药18个月，对48例皮质类固醇诱导的骨质疏松症患者腰椎（LS）、股骨颈（FN）和股骨中段（FS）骨密度（BMD）的影响。MFP - 钙治疗组和对照组的平均年龄分别为49.4±3.1岁和51.6±3.0岁，皮质类固醇治疗时间分别为7.5±1.8年和9.3±1.7年，泼尼松平均每日剂量分别为18.2±2.3毫克和12.1±1.1毫克。MFP - 钙治疗组和对照组初始BMD（以Z值表示，即与年龄和性别匹配的正常受试者标准差的差异），LS分别为 - 1.5±0.2和 - 1.2±0.2，FN分别为 - 1.4±0.2和 - 1.3±0.2，FS分别为 - 0.8±0.3和 - 0.6±0.3。对每6个月测量值进行线性回归分析显示，随访18个月后，MFP - 钙治疗组和对照组的LS的BMD变化分别为 + 7.8±2.2%对 + 3.6±1.3%（p < 0.02），FN为 - 1.5±1.8%对 + 0.9±1.8%，FS为 - 1.1±1.1%对 - 0.5±1.4%。（摘要截取自250字）
