Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group.
Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group.
复制标题
阿仑膦酸钠治疗期间骨矿物质密度的较大增加与绝经后骨质疏松症女性新发椎骨骨折的风险较低相关。
作者：
M. Hochberg;P. Ross;D. Black;S. Cummings;H. Genant;M. Nevitt;E. Barrett;T. Musliner;D. Thompson
目标
探讨阿仑膦酸钠治疗期间椎骨骨折的发生率是否与骨矿物质密度（BMD）的变化幅度有关。
方法
本研究中的女性年龄为 55-81 岁 (n = 2,984)。在参加骨折干预试验时，他们在 2 年内每天服用 5 毫克阿仑膦酸钠，随后在研究的剩余 12-30 个月中每天服用 10 毫克阿仑膦酸钠。他们在基线以及 12 和 24 个月时测量了 BMD，并在基线时以及 36 或 48 个月时再次获取脊柱 X 光片，以识别新的椎骨骨折。
结果
经过 12 个月的阿仑膦酸钠治疗后，35% 的参与者总髋部 BMD 增加≥3%，21% 的参与者总髋部 BMD 降低或没有变化。前 12 个月内髋部总 BMD 增加较大的女性在整个随访期间新发椎骨骨折的发生率较低。髋部总 BMD 增加 > 或 = 3% 的女性中，只有 3.2% 发生新的椎骨骨折，而 BMD 下降或保持不变的女性的两倍 (6.3%) 发生新骨折（调整后比值比 0.45，95% 置信区间 0.27-0.72）。在 12 个月时的脊柱 BMD 以及 24 个月时使用 BMD 变化的两个部位都观察到了类似的模式。
结论
在阿仑膦酸钠治疗的前 1 或 2 年中，BMD 增加 > 或 = 3% 的女性新发椎骨骨折的发生率最低。这些研究结果表明，在服用抗骨吸收药物的女性中，骨密度的增加与新发椎骨骨折风险的降低相关。
OBJECTIVE
To investigate whether the incidence of vertebral fractures is related to the magnitude of change in bone mineral density (BMD) during alendronate treatment.
METHODS
Women in this study were age 55-81 years (n = 2,984). While participating in the Fracture Intervention Trial, they received 5 mg/day of alendronate for 2 years followed by 10 mg/day for the remaining 12-30 months of the study. Their BMD was measured at baseline and at 12 and 24 months, and spine radiographs were obtained at baseline and again at 36 or 48 months to identify new vertebral fractures.
RESULTS
After 12 months of alendronate treatment, 35% of participants had increases of > or =3% in total hip BMD, and 21% had either decreased total hip BMD or no change. Women who had larger increases in total hip BMD during the first 12 months had a lower incidence of new vertebral fractures during the entire followup period. Only 3.2% of women with increases of > or =3% in total hip BMD experienced new vertebral fractures, whereas twice as many women (6.3%) whose BMD declined or stayed the same experienced new fractures (adjusted odds ratio 0.45, 95% confidence interval 0.27-0.72). Similar patterns were observed for spine BMD at 12 months, and for both sites using change in BMD at 24 months.
CONCLUSION
Women with increases of > or =3% in BMD during the first 1 or 2 years of alendronate treatment had the lowest incidence of new vertebral fractures. These findings suggest that, among women taking antiresorptive agents, greater increases in BMD are associated with lower risk of new vertebral fractures.