Microcrack frequency and bone remodeling in postmenopausal osteoporotic women on long-term bisphosphonates: A bone biopsy study
Microcrack frequency and bone remodeling in postmenopausal osteoporotic women on long-term bisphosphonates: A bone biopsy study
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DOI：
10.1359/jbmr.070609
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发表时间：
2007-10-01
影响因子：
6.2
通讯作者：
Delmas, Pierre D.
中科院分区：
文献类型：
--
作者：
Chapurlat, Roland D.;Arlot, Monique;Delmas, Pierre D.
简介：动物实验表明，二磷酸盐（BPS）可剂量依赖性地增加骨转换过度抑制引起的微损伤频率。然而，在接受BP治疗剂量>3年的人类中存在有限的数据。我们测量了50名绝经后骨质疏松妇女髂骨活检标本的微裂纹频率和组织形态计量学参数（平均年龄= 68岁）接受过BP治疗（3例静脉注射帕米膦酸盐，37例口服阿仑膦酸盐，10例口服利塞膦酸盐）至少3年（平均治疗持续时间= 6.5年）。我们将这些结果与12具尸体的经髂骨骨活检进行了比较。我们使用绿色钙黄绿素作为荧光染料进行整体染色。使用光学显微镜在三个100 μ m厚的切片中对微裂纹进行定量，并通过激光共聚焦显微镜进行确认。使用非参数检验比较治疗组和对照组的微裂纹频率（微裂纹数/mm（2）骨组织）。我们还探讨了微裂纹频率的预测因素，包括年龄、BP治疗持续时间和激活frequency.Results：在接受治疗的女性中，松质骨微裂纹频率较低（平均为0.13微裂纹/mm（2）），与对照组相比无显著差异（0.05微裂纹/mm（2）; P = 0.59）。值得注意的是，54%的治疗组女性和58%的对照组女性没有可观察到的微裂纹。微裂纹频率和BP治疗持续时间之间没有相关性（对于微裂纹S/mm（2）和持续时间，斯皮尔曼r = 0.04，p = 0.80），患者年龄和微裂纹数量之间也没有相关性（斯皮尔曼r =-0.09，p = 0.61）。尽管骨重建参数在治疗的妇女中受到抑制，但我们发现微裂纹密度和激活频率之间没有关系（斯皮尔曼r =-0.003，p = 0.99）。此外，微裂纹的频率并没有增加，在妇女与流行的椎骨骨折相比，没有fractions.Conclusions：在绝经后骨质疏松症妇女长期BPS，微裂纹的频率在髂骨是低的，尽管骨转换显着减少。
Introduction: Animal studies suggest that bisphosphonates (BPS) could increase microdamage frequency in a dose-dependent manner, caused by excessively suppressed bone turnover. However, there is limited data in humans receiving BP therapeutic doses for >3 yr.Materials and Methods: We measured microcrack frequency and histomorphometry parameters on transiliac bone biopsies in 50 postmenopausal osteoporotic women (mean age = 68 yr) who had received BP therapy (3 on intravenous pamidronate, 37 on oral alendronate, and 10 on oral risedronate) for at least 3 yr (mean treatment duration = 6.5 yr). We compared these results with transiliac bone biopsies obtained from 12 cadavers. We used bulk staining with green calcein as a fluorochrome. The microcracks were quantified in three 100-mu m-thick sections using optic microscopy and were confirmed by laser confocal microscopy. Microcrack frequency (number of microcracks/mm(2) of bone tissue) was compared between treated women and controls using nonparametric tests. We also explored predictors of microcrack frequency, including age, duration of BP therapy, and activation frequency.Results: Among treated women, cancellous bone microcrack frequency was low (mean, 0.13 microcracks/mm(2)) and did not differ significantly from that observed in controls (0.05 microcracks/mm(2); P = 0.59). Of note, 54% of the treated women and 58% of the controls had no observable Microcracks. There was no association between microcrack frequency and the duration of BP therapy (for microcrackS/mm(2) and duration, Spearman r = 0.04, p = 0.80) and between patients' ages and the number of microcracks (Spearman r = -0.09, p = 0.61). Although bone remodeling parameters were suppressed in treated women, we found no relationship between microcrack density and activation frequency (Spearman r = -0.003, p = 0.99). Also, microcrack frequency was not increased in women with prevalent vertebral fracture compared with those without fractures.Conclusions: Among postmenopausal osteoporotic women on long-term BPS, microcrack frequency in the iliac bone is low, despite a marked reduction of bone turnover.