Risedronate preserves bone architecture in postmenopausal women with osteoporosis as measured by three-dimensional microcomputed tomography
Risedronate preserves bone architecture in postmenopausal women with osteoporosis as measured by three-dimensional microcomputed tomography
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DOI：
10.1016/j.bone.2003.12.013
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发表时间：
2004-04-01
期刊：
影响因子：
4.1
通讯作者：
Manhart, MD
中科院分区：
文献类型：
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作者：
Borah, B;Dufresne, TE;Manhart, MD
骨转换率升高引起的骨小梁微结构的恶化越来越被认为是骨质疏松性骨折发病机制的一个因素。我们研究了绝经后骨质疏松妇女使用利塞膦酸钠降低骨转换对骨小梁结构的影响。使用3-D微型计算机断层扫描分析了接受利塞膦酸钠5 mg/d（n = 21）或安慰剂（n = 17）治疗患者治疗3年前后的髂嵴骨活检标本。我们发现安慰剂组的基线骨转换和骨丢失之间存在显著相关性，这为更高的转换诱导更高的骨丢失导致更大程度的结构退化提供了证据。当患者根据基线骨转换分为两组时（MS/BS小于或大于整个队列的中位数），骨小梁体积显著减少（BV/TV，P = 0.009）和小梁厚度（Tb.Th*，P = 0.008）和骨髓星星体积（Ma.St.V，P = 0.008）的增加，这是小梁孔隙度的一种量度，在较高转换率（MS/BS>中位数）的安慰剂治疗患者中观察到。结构模型指数（SMI P = 0.028）和骨表面/骨体积比（BS/BV，P = 0.006）增加表明，骨小梁结构从板转移到杆。较低周转率（MS/BS）较基线的变化
The deterioration of trabecular microarchitecture induced by elevated bone turnover is increasingly recognized as a factor in the pathogenesis of osteoporotic fractures. We investigated the effect of the reduction of turnover with risedronate on trabecular architecture in postmenopausal women with osteoporosis. Iliac crest bone biopsy specimens taken before and after 3 years of treatment from patients receiving risedronate 5 mg daily (n = 21) or placebo (n = 17) were analyzed using 3-D microcomputed tomography. We found a significant correlation between baseline bone turnover and bone loss in the placebo group, providing evidence that higher turnover induced higher bone loss leading to a greater degree of architectural degradation. When patients were classified into two groups based on baseline bone turnover (MS/BS less than or greater than the median value for the entire cohort), significant decreases in trabecular bone volume (BV/TV, P = 0.009) and trabecular thickness (Tb.Th*, P = 0.008) and an increase in marrow star volume (Ma.St.V, P = 0.008), a measure of trabecular porosity, were observed in the higher turnover (MS/BS>median) placebo-treated patients. The trabecular structure shifted from plates to rods as shown by an increase in structure model index (SMI P = 0.028) and bone surface to bone volume ratio (BS/BV, P = 0.006). The changes from baseline in the lower turnover (MS/BS