The effects of parathyroid hormone, alendronate, or both in men with osteoporosis
The effects of parathyroid hormone, alendronate, or both in men with osteoporosis
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DOI：
10.1056/nejmoa035725
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发表时间：
2003-09-25
影响因子：
158.5
通讯作者：
Neer, RM
中科院分区：
文献类型：
--
作者：
Finkelstein, JS;Hayes, A;Neer, RM
背景：由于甲状旁腺激素增加骨形成和骨吸收，甲状旁腺激素联合抗骨吸收剂可能会增强其对骨矿物质密度的影响。方法：我们随机分配83名年龄在46 - 85岁、骨密度低的男性接受阿仑膦酸钠（每日10毫克，28名男性）、甲状旁腺激素（每日皮下注射40毫克，27名男性）或两者兼用（28名男性）。阿仑膦酸钠治疗30个月；第6个月开始甲状旁腺激素治疗。采用双能x线骨密度仪每半年测量一次腰椎、股骨近端、桡骨轴和全身的骨密度。在基线和第30个月用定量计算机断层扫描测量腰椎骨小梁骨密度。每6个月测定一次血清碱性磷酸酶水平。主要终点是脊柱后前位骨矿物质密度的变化率。结果：单独使用甲状旁腺激素治疗的男性腰椎骨密度明显高于其他治疗组(P
BACKGROUND:Because parathyroid hormone increases both bone formation and bone resorption, it is possible that combining parathyroid hormone with an antiresorptive agent will enhance its effect on bone mineral density.METHODS:We randomly assigned 83 men who were 46 to 85 years of age and had low bone density to receive alendronate (10 mg daily; 28 men), parathyroid hormone (40 microg subcutaneously daily; 27 men), or both (28 men). Alendronate therapy was given for 30 months; parathyroid hormone therapy was begun at month 6. The bone mineral density of the lumbar spine, proximal femur, radial shaft, and total body was measured every six months with the use of dual-energy x-ray absorptiometry. Trabecular bone mineral density of the lumbar spine was measured at base line and month 30 by means of quantitative computed tomography. Serum alkaline phosphatase levels were measured every six months. The primary end point was the rate of change in the bone mineral density at the posteroanterior spine.RESULTS:The bone mineral density at the lumbar spine increased significantly more in men treated with parathyroid hormone alone than in those in the other groups (P