Bone turnover markers as an aid to monitor osteoporosis following allogeneic hematopoietic stem cell transplantation
Bone turnover markers as an aid to monitor osteoporosis following allogeneic hematopoietic stem cell transplantation
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DOI：
10.1007/s00277-020-04090-7
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发表时间：
2020-05-25
影响因子：
3.5
通讯作者：
Ohashi, Kazuteru
中科院分区：
文献类型：
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作者：
Kurosawa, Shuhei;Doki, Noriko;Ohashi, Kazuteru
骨转换标志物(BTM)是评估骨折风险的有用参数，与骨密度(BMD)不同，它可以在任何机构测量。然而，异基因造血干细胞移植(allo-HSCT)后患者的BTM值尚未确定。通过检测移植前1个月和移植后6个月血清骨吸收标记物抗酒石酸酸性磷酸酶5b(TRACP-5b)和骨形成标记物骨形成特异性碱性磷酸酶(BAP)水平以及骨密度，探讨BTMS在allo-HSCT患者中的实用性。患者被分为两组，一组在allo-HSCT前或移植后1个月内给予阿伦磷酸钠治疗(n=14)(每周口服35 mg)，另一组(n=16)不接受阿伦磷酸治疗。尽管使用皮质类固醇的频率较高(71.4vs.18.9%；p<；0.01)，但腰椎(-2.9vs.3.1%；p=0.44)和股骨颈(-3.2vs.4.1%；p=1.00)、TRACP-5b水平(-4.8vs.9.9%；p=0.45)和BAP水平(6.9vs.1.0%；P=0.85)在6个月内，阿仑膦酸钠组与对照组之间无显著差异。此外，腰椎骨密度的变化百分比与移植后6个月的TRACP-5b水平呈负相关(p=0.03，r=0.40)。我们的结果表明阿伦磷酸钠对allo-HSCT患者的治疗可能有效。BTM水平可用于监测BMD的变化。
Bone turnover markers (BTMs) are useful parameters for assessing fracture risk and unlike bone mineral density (BMD), can be measured at any institution. However, BTM values have not been established in patients post-allogeneic hematopoietic stem cell transplantation (allo-HSCT). We investigated the practicality of BTMs in patients who underwent allo-HSCT by measuring levels of the serum bone resorption marker, tartrate-resistant acid phosphatase-5b (TRACP-5b), and the bone formation marker, bone-specific alkaline phosphatase (BAP), together with BMD, 1 month before and 6 months after allo-HSCT. Patients were classified into either the alendronate group (n = 14) if alendronate treatment (35 mg orally per week) was administered before allo-HSCT or within 1 month after allo-HSCT, or the control group (n = 16), in which patients did not receive alendronate treatment. Despite the high frequency of corticosteroids users in the alendronate group (71.4 vs. 18.9%; p < 0.01), the mean percentage changes in BMD at the lumbar spine (- 2.9 vs. - 3.1%; p = 0.44) and femoral neck (- 3.2 vs. - 4.1%; p = 1.00), TRACP-5b levels (- 4.8 vs. 9.9%; p = 0.45), and BAP levels (6.9 vs. 1.0%; p = 0.85) during 6 months did not differ significantly between the alendronate and control groups. Additionally, the percentage changes in BMD at the lumbar spine were negatively associated with the TRACP-5b levels 6 months after allo-HSCT (p = 0.03, r = 0.40). Our results indicate the possible effectiveness of alendronate treatment in allo-HSCT patients. BTM levels could be useful to monitor the BMD changes.