The effect of risedronate on bone mineralization as measured by micro-computed tomography with synchrotron radiation: Correlation to histomorphometric indices of turnover
The effect of risedronate on bone mineralization as measured by micro-computed tomography with synchrotron radiation: Correlation to histomorphometric indices of turnover
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DOI：
10.1016/j.bone.2005.03.017
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发表时间：
2005-07-01
期刊：
影响因子：
4.1
通讯作者：
Turner, RT
中科院分区：
文献类型：
--
作者：
Borah, B;Ritman, EL;Turner, RT
本研究的主要目的是确定绝经后骨质疏松症妇女接受利塞膦酸钠或安慰剂治疗3年后骨矿化的变化。第二个目标是确定矿化和骨转换指数之间的关系，在同一活检中测量。矿化程度是通过使用同步辐射（Synchrotron - ct）的微计算机断层扫描在基线和治疗3年后对经髂活检的小梁骨进行测量的，这些患者每天接受5毫克利塞地酸钠（n = 11）或安慰剂（n = 8）。在利塞膦酸治疗的患者中，3年平均矿化（Avg-MIN）和矿化峰（peak - min）分别较基线显著升高4.7% （P < 0.0001）和5.4% (P = 0.0003)，且与周转率指数呈显著负相关。在安慰剂治疗的患者中，Avg-MIN（2.0%）和Peak-MIN（1.6%）的增加与基线无显著差异，与周转指数的相关性较弱。利塞膦酸钠显著降低了低矿化骨与高矿化骨的比例（按体积（BMR-V）和表面积（BMR-S）计算），分别较基线降低了70.1%和54.1%。这些变化与通过矿化表面MS/BS（-72.8%）减少评估的基线周转率显著降低一致；激活频率Ac.F (-60.4%)；和骨形成率，BFR-BV（-63.6%）在相同的活检中，利塞膦酸治疗的患者。比较基线的成对变化，与安慰剂相比，利塞膦酸钠显著降低了低矿化骨分数，BMR-V （P = 0.015）和BMR-S （P = 0.035）的降低幅度更大。利塞膦酸钠组BMR-V和BMR-S与MS/BS呈显著正相关（R-2分别为0.83和0.92）。Ac.F和BFR-BV的相关性也很显著，其中BMR-S的相关性较强（R-2分别为0.77和0.79）。这些数据表明，BMR-V和BMR-S是骨小梁转换的标志物，可用于评估骨活检中对转换的治疗效果。结果表明，利塞膦酸钠减少骨周转量增加了矿化程度，降低了低矿化与高矿化骨组分的比例，从而增加了骨的抗骨折能力。(C) 2005爱思唯尔公司版权所有。
The primary goal of our study was to determine changes in bone mineralization in postmenopausal osteoporotic women treated for 3 years with risedronate or placebo. A secondary goal was to determine the relationship between mineralization and indices of bone turnover measured on the same biopsies. The degree of mineralization was measured by micro-computed tomography using Synchrotron radiation (Synchrotron mu-CT) in the trabecular bone of paired transiliac biopsies taken at baseline and after 3 years of treatment from patients receiving risedronate 5 mg daily (n = 11) or placebo (n = 8). In the risedronate-treated patients, the average mineralization (Avg-MIN) and peak mineralization (Peak-MIN) at 3 years were significantly increased from baseline by 4.7% (P < 0.0001) and 5.4% (P = 0.0003), respectively and showed significant negative correlation to turnover indices. In the placebo-treated patients, the increases in Avg-MIN (2.0%) and Peak-MIN (1.6%) were not significantly different from baseline and correlation to turnover indices was weaker. Risedronate significantly reduced the ratio of low- to high-mineralized bone fractions estimated by volume (BMR-V) and surface area (BMR-S) by 70.1% and 54.1%, respectively from baseline. These changes were consistent with the significant reduction of turnover from baseline assessed by reductions in mineralizing surface, MS/BS (-72.8%); activation frequency, Ac.F (-60.4%); and bone formation rate, BFR-BV (-63.6%) in the same biopsies in the risedronate-treated patients. Comparing the pair-wise changes from baseline, risedronate significantly reduced the low-mineralized bone fraction in comparison to placebo, as indicated by a larger reduction of BMR-V (P 0.015) and BMR-S (P = 0.035). In the risedronate group, BMR-V and BMR-S showed significant positive correlation to MS/BS (R-2: 0.83 and 0.92, respectively). The correlations to Ac.F and BFR-BV were also significant, with BMR-S showing a strong relation (R-2: 0.77 and 0.79, respectively). The data suggest that BMR-V and BMR-S are markers of turnover of trabecular bone and may be used to assess treatment effect on turnover in bone biopsies. The results demonstrate that the reduction of turnover by risedronate increased the degree of mineralization and reduced the ratio of low- to high-mineralized bone fractions which may increase bone's resistance to fracture. (C) 2005 Elsevier Inc. All rights reserved.