Effects of cyclical etidronate with alfacalcidol on lumbar bone mineral density, bone resorption, and back pain in postmenopausal women with osteoporosis.
Effects of cyclical etidronate with alfacalcidol on lumbar bone mineral density, bone resorption, and back pain in postmenopausal women with osteoporosis.
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DOI：
10.1007/s00776-003-0655-5
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发表时间：
2003-01-01
期刊：
影响因子：
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通讯作者：
Uzawa, Mitsuyoshi
中科院分区：
文献类型：
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作者：
Iwamoto, Jun;Takeda, Tsuyoshi;Uzawa, Mitsuyoshi
本研究是一项开放、随机、前瞻性的研究，目的是比较联合阿法骨化醇和单用周期依替磷酸对绝经后骨质疏松症妇女腰椎骨密度(BMD)、骨吸收和背痛的影响。选择40例绝经后骨质疏松症患者，年龄60~86岁，腰椎无骨折，随机分为两组，每组20例。一组给予依替磷酸二钠200 mg/d口服，每3个月1次，共2周；另一组给予依替磷酸二钠加阿法骨化醇，每日1次，连用1次。用双能X线骨密度仪测定腰椎(L1~L4)的骨密度，用酶联免疫吸附试验测定尿I型胶原N端末端肽(NTX)，用面部评分评价腰背痛。两组患者在年龄、体重指数、绝经年限、腰椎骨密度、尿NTX水平和脸部量表评分等基线指标上均无显著差异。两种治疗方法均可显著降低尿中NTX水平，减少腰背痛。联合应用阿法骨化醇可显著提高腰椎骨密度，尿NTX水平较单用依替磷酸更显著降低，但单用依替磷酸并不能显著增加腰椎骨密度。两组患者的腰背痛缓解情况相似。这些结果表明，在绝经后骨质疏松症妇女中，联合应用周期依替膦酸盐和阿法骨化醇似乎比单用周期依替膦酸盐更能有效地抑制骨吸收，从而增加腰椎骨密度。
The purpose of the present open-labeled, randomized, prospective study was to compare the effects of cyclical etidronate combined with alfacalcidol with those of cyclical etidronate alone on lumbar bone mineral density (BMD), bone resorption, and back pain in postmenopausal women with osteoporosis. Forty postmenopausal women with osteoporosis, 60-86 years of age, without any vertebral fractures in the lumbar spine, were randomly divided into two groups with 20 patients in each group. One group was treated with cyclical etidronate (oral etidronate 200 mg daily for 2 weeks every 3 months) and the other was given cyclical etidronate combined with alfacalcidol (cyclical etidronate plus alfacalcidol 1 Ig daily continuously). The BMD of the lumbar spine (L1-L4) measured by dual-energy X-ray absorptiometry, urinary crosslinked N-terminal telopeptides of type I collagen (NTX) measured by an enzyme-linked immunosorbent assay, and back pain evaluated by the face scale score were assessed at baseline, 6 months, and 12 months. There were no significant differences in baseline characteristics including age, body mass index, years since menopause, lumbar BMD, urinary NTX level, and face scale score between the two treatment groups. Both treatments significantly reduced the urinary NTX level and back pain. Cyclical etidronate combined with alfacalcidol significantly increased the lumbar BMD with a more significant reduction in the urinary NTX level than cyclical etidronate alone, but cyclical etidronate alone did not significantly increase the lumbar BMD. Alleviation of back pain was similar in the two groups. These results suggest that cyclical etidronate combined with alfacalcidol appears to be more useful than cyclical etidronate alone for increasing the lumbar BMD by more markedly suppressing bone resorption in postmenopausal women with osteoporosis.