Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.
Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.
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DOI：
10.1097/00006254-199008000-00016
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发表时间：
1990-03
期刊：
影响因子：
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通讯作者：
B. Riggs;S. Hodgson;W. O'Fallon;E. Chao;H. Wahner;J. Muhs;S. L. Cedel;L. Joseph Melon
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文献类型：
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作者：
B. Riggs;S. Hodgson;W. O'Fallon;E. Chao;H. Wahner;J. Muhs;S. L. Cedel;L. Joseph Melon
虽然氟化物增加了骨量，但新形成的骨骼可能会降低强度。为了评估氟化物治疗对骨质疏松症骨折率的影响，我们对202名患有骨质疏松症和椎体骨折的绝经后妇女进行了一项为期四年的前瞻性临床试验，随机分配给她们服用氟化钠（每天75毫克）或安慰剂。所有人都服用钙补充剂（每天1500毫克）。氟化物组的66名妇女和安慰剂组的69名妇女完成了试验。与安慰剂组相比,治疗组在平均增加35%的骨矿物质密度(P小于0.0001)在腰椎(主要是松质骨)、12% (P小于0.0001)股骨颈,和10% (P小于0.0001)在股骨转子(混合皮质和松质骨的网站),但骨密度下降了4% (P小于0.02)轴的半径(主要是皮质骨)。治疗组与安慰剂组新发椎体骨折数相似（分别为163例和136例，P值无统计学意义），但治疗组非椎体骨折数较高（72例比24例，P值< 0.01）。氟化物组54名妇女和安慰剂组24名妇女的副作用严重到需要减少剂量；主要的副作用是胃肠道症状和下肢疼痛。我们得出结论，氟化物治疗增加松质骨，但降低皮质骨矿物质密度，增加骨骼脆弱性。因此，在本研究条件下，氟化物-钙方案不能有效治疗绝经后骨质疏松症。
Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day). Sixty-six women in the fluoride group and 69 women in the placebo group completed the trial. As compared with the placebo group, the treatment group had increases in median bone mineral density of 35 percent (P less than 0.0001) in the lumbar spine (predominantly cancellous bone), 12 percent (P less than 0.0001) in the femoral neck, and 10 percent (P less than 0.0001) in the femoral trochanter (sites of mixed cortical and cancellous bone), but the bone mineral density decreased by 4 percent (P less than 0.02) in the shaft of the radius (predominantly cortical bone). The number of new vertebral fractures was similar in the treatment and placebo groups (163 and 136, respectively; P not significant), but the number of nonvertebral fractures was higher in the treatment group (72 vs. 24; P less than 0.01). Fifty-four women in the fluoride group and 24 in the placebo group had side effects sufficiently severe to warrant dose reduction; the major side effects were gastrointestinal symptoms and lower-extremity pain. We conclude that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility. Thus, under the conditions of this study, the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.