Trabecular bone microcrack accumulation in patients treated with bisphosphonates for durations up to 16 years.
Trabecular bone microcrack accumulation in patients treated with bisphosphonates for durations up to 16 years.
复制标题
使用双磷酸盐治疗长达 16 年的患者的骨小梁微裂纹累积。
DOI：
10.1002/jor.25441
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Malluche,HartmutH
中科院分区：
文献类型：
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作者：
Pienkowski,David;Wood,ConstanceL;Malluche,HartmutH
本研究量化了接受双膦酸盐治疗的患者骨中微裂纹的长度、数量和密度，作为持续时间的函数。通过骨活检获得了51例连续口服双膦酸盐1-16年的骨质疏松症白人女性的前髂嵴骨样本。对样本进行组织学处理并分析骨面积、微裂纹数量和微裂纹长度。分析使用统计建模，并将患者年龄、骨矿物质密度、骨体积/总体积、骨小梁厚度和骨转换视为潜在协变量。微裂纹密度（微裂纹数量/总检查骨面积）与双膦酸盐治疗持续时间呈线性相关（p= 0.018）。分析的协变量均未对观察到的微裂纹密度和双膦酸盐治疗持续时间之间的关系做出显著贡献。随着双膦酸盐治疗持续时间的增加，观察到的微裂纹密度增加是重要的，因为微裂纹水平的增加不仅可能影响骨重建，还可能降低弹性模量，并被怀疑对可能影响骨折风险的其他机械性能产生不利影响。本研究结果补充了我们先前的结果，显示骨材料性质和模量随双膦酸盐治疗持续时间的变化，从而提供了双膦酸盐治疗持续时间和骨质量之间关系的更全面评估。临床意义声明：本研究结果提供了指导口服双膦酸盐用于绝经后骨质疏松症治疗的临床使用的信息。
This study quantified the length, number, and density of microcracks in bone from patients treated with bisphosphonates as a function of duration. Anterior iliac crest bone samples from 51 osteoporotic Caucasian females continuously treated with oral bisphosphonates for 1–16 years were obtained by bone biopsy. Samples were histologically processed and analyzed for bone area, microcrack number, and microcrack length. The analyses used statistical modeling and considered patient age, bone mineral density, bone volume/total volume, trabecular thickness, and bone turnover as potential covariates. Microcrack density (number of microcracks/total examined bone area) was linearly related (p= 0.018) to bisphosphonate treatment duration. None of the analyzed covariates contributed significantly to the observed relationship between microcrack density and bisphosphonate treatment duration. Observed increases in microcrack density with increasing bisphosphonate treatment duration is important because increasing levels of microcracks may not only affect bone remodeling but also reduce elastic modulus and are suspected to adversely affect other mechanical properties that may influence fracture risk. The present findings add to our prior results showing changes in bone material properties and modulus with bisphosphonate treatment duration and thereby provide a more comprehensive assessment of the relationship between bisphosphonate treatment duration and bone quality. Statement of Clinical Significance: The present findings provide information guiding clinical use of oral bisphosphonates for post‐menopausal osteoporosis therapy.