Shen V, Birchman R, Liang X G, Wu D D, Dempster D W, Lindsay R
Regional Bone Center, Helen Hayes Hospital, New York State Department of Health, West Haverstraw 10993, USA.
J Bone Miner Res. 1998 May;13(5):883-90. doi: 10.1359/jbmr.1998.13.5.883.
Intermittent administration of parathyroid hormone (PTH) has been shown to be an anabolic agent for animal and human skeletons. In previous studies, PTH has been used concurrent with, or subsequent to, the onset of bone loss. However, it is entirely possible that PTH may be used as an anabolic agent in a situation where there is stable skeletal remodeling. Increasing bone mass at this time might confer long-lasting beneficial effects when bone loss begins, for example, subsequent to the loss of ovarian function. To test this hypothesis, we evaluated the effects of administering rat PTH(1-34) (80 microg/kg/day, subcutaneously [s.c.]) to 6-month-old rats for a 2-week period prior to ovariectomy, and followed the natural occurrence of bone loss over a 14-week period. To determine the effects of estrogen intervention on bone gained by PTH treatment, one group was repleted with 17beta-estradiol (10 microg/kg/day via s.c. implant). Serial measurements of bone mass in vivo at the distal femur were obtained at 2-week intervals using dual-energy X-ray absorptiometry, while histologic and mechanical strength data were obtained from excised proximal tibiae and distal femurs after sacrifice. Two weeks of PTH treatment resulted in an increase of bone mineral density (BMD), mechanical strength, and cancellous bone volume (CnBV/TV). Four weeks after PTH withdrawal, significant residual beneficial effects on BMD and strength, irrespective of ovarian status, were observed. However, 14 weeks after PTH withdrawal, although there were still residual effects on CnBV/TV in ovariectomized animals pretreated with PTH, the PTH effects on BMD and mechanical strength had been lost. Estradiol repletion during the rapid bone loss phase following ovariectomy prevented the reduction in BMD associated with either ovariectomy or PTH withdrawal. Our results suggest that: treatment of rats with PTH prior to ovariectomy produces an increase in BMD and strength, these beneficial effects extend for a period of at least three times the treatment duration, the BMD that is lost when PTH is discontinued equates to the amount accrued during the PTH treatment, estrogen replacement can be used to maintain the bone gained as a result of PTH treatment.
甲状旁腺激素(PTH)的间歇性给药已被证明是一种对动物和人类骨骼具有合成代谢作用的药物。在先前的研究中,PTH是在骨质流失开始时同时使用或在其后使用。然而,PTH完全有可能在骨骼重塑稳定的情况下用作合成代谢药物。此时增加骨量可能在骨质流失开始时,例如在卵巢功能丧失后,带来持久的有益效果。为了验证这一假设,我们评估了在卵巢切除术前2周对6月龄大鼠皮下注射大鼠PTH(1-34)(80微克/千克/天)2周的效果,并在14周内跟踪骨质流失的自然发生情况。为了确定雌激素干预对PTH治疗所增加骨量的影响,一组大鼠通过皮下植入补充17β-雌二醇(10微克/千克/天)。使用双能X线吸收法每隔2周对活体大鼠股骨远端进行骨量的连续测量,而组织学和力学强度数据则在处死动物后从切除的胫骨近端和股骨远端获得。PTH治疗2周导致骨矿物质密度(BMD)、力学强度和松质骨体积(CnBV/TV)增加。停止PTH治疗4周后,无论卵巢状态如何,对BMD和强度均观察到显著的残余有益效果。然而,停止PTH治疗14周后,尽管在PTH预处理的去卵巢动物中对CnBV/TV仍有残余影响,但PTH对BMD和力学强度的影响已经消失。卵巢切除术后快速骨质流失阶段的雌二醇补充可防止与卵巢切除或停止PTH治疗相关的BMD降低。我们的结果表明:卵巢切除术前用PTH治疗大鼠可使BMD和强度增加,这些有益效果至少持续治疗持续时间的三倍,停止PTH治疗时丢失的BMD等同于PTH治疗期间积累的量,雌激素替代可用于维持PTH治疗所增加的骨量。