Effects of long-term alendronate treatment on bone mineralisation, resorption parameters and biomechanics of single human vertebral trabeculae.
Effects of long-term alendronate treatment on bone mineralisation, resorption parameters and biomechanics of single human vertebral trabeculae.
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DOI：
10.22203/ecm.v028a12
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发表时间：
2014-09
影响因子：
3.1
通讯作者：
M. Krause;M. Soltau;E. Zimmermann;M. Hahn;J. Kornet;A. Hapfelmeier;S. Breer;M. Morlock;B. Wulff;K. Püschel;Glueer Cc;M. Amling;B. Busse
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文献类型：
--
作者：
M. Krause;M. Soltau;E. Zimmermann;M. Hahn;J. Kornet;A. Hapfelmeier;S. Breer;M. Morlock;B. Wulff;K. Püschel;Glueer Cc;M. Amling;B. Busse
由于其良好的骨折风险降低，双膦酸盐是最常用的治疗骨质疏松症的治疗药物。双膦酸盐通过抑制骨吸收降低骨折风险，但较低的骨转换可能对组织水平的骨质量产生负面影响。在这里，我们直接评估了未治疗的腰椎（L5）的松质骨的结构和力学特征，对照组（n=21），中期阿仑膦酸钠治疗的腰椎间盘突出症患者（n=6），长期阿仑膦酸钠治疗的腰椎间盘突出症患者（n=7）。单个骨小梁的强度和韧性进行了评价，而结构的特点是通过测量微损伤积累，矿化分布和组织学指标。与未治疗的对照组（p=0.037）相比，阿仑膦酸钠治疗的病例具有减少的侵蚀表面（ES/BS，p<0.001）和更高的骨矿化，这表明与治疗相关的低转换。然而，微损伤量和机械性能在对照组和处理组之间相似。由于与未治疗的骨质疏松对照组相比，阿仑膦酸钠治疗组的组织矿物质密度（TMD）显著增加，因此吸收腔的减少可以抵消较高的TMD，从而使阿仑膦酸钠治疗的骨保持其机械性能并抵抗微损伤累积。对可能的预测因子的多变量分析支持多因素（例如，体重指数、TMD和ES/BS）可影响机械性能。我们的研究结果表明，长期阿仑膦酸钠治疗对松质骨的力学特性没有不良影响。
Due to their well-established fracture risk reduction, bisphosphonates are the most frequently used therapeutic agent to treat osteoporosis. Bisphosphonates reduce fracture risk by suppressing bone resorption, but the lower bone turnover could have a negative impact on bone quality at the tissue level. Here, we directly assess the structural and mechanical characteristics of cancellous bone from the lumbar vertebrae (L5) in non-treated osteoporotic controls (n=21), mid-term alendronate-treated osteoporotic patients (n=6), and long-term alendronate-treated osteoporotic patients (n=7). The strength and toughness of single trabeculae were evaluated, while the structure was characterised through measurements of microdamage accumulation, mineralisation distribution, and histological indices. The alendronate-treated cases had a reduced eroded surface (ES/BS, p<0.001) and a higher bone mineralisation in comparison to non-treated controls (p=0.037), which is indicative of low turnover associated with treatment. However, the amount of microdamage and the mechanical properties were similar among the control and treatment groups. As the tissue mineral density (TMD) increased significantly with alendronate treatment compared to non-treated osteoporotic controls, the reduction in resorption cavities could counterbalance the higher TMD allowing the alendronate-treated bone to maintain its mechanical properties and resist microdamage accumulation. A multivariate analysis of the possible predictors supports the theory that multiple factors (e.g., body mass index, TMD, and ES/BS) can impact the mechanical properties. Our results suggest that long-term alendronate treatment shows no adverse impact on mechanical cancellous bone characteristics.