Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: The Fracture Intervention Trial
Change in bone turnover and hip, non-spine, and vertebral fracture in alendronate-treated women: The Fracture Intervention Trial
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DOI：
10.1359/jbmr.040512
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发表时间：
2004-08-01
影响因子：
6.2
通讯作者：
Delmas, PD
中科院分区：
文献类型：
--
作者：
Bauer, DC;Black, DM;Delmas, PD
我们使用来自骨折干预试验的数据来评估6186名绝经后妇女接受阿仑膦酸钠或安慰剂治疗1年后骨转换的变化与随后髋部、非脊柱和脊柱骨折风险的关系。阿伦膦酸盐组（n = 3105），一个或多个生化标志物的降低与骨折风险降低相关。简介：在双磷酸盐治疗的妇女中，骨转换生化标志物的短期变化与非脊柱骨折风险之间的关系数据很少，这种测量的临床应用尚不清楚。材料和方法：我们测量了骨转换的生化标志物（骨特异性碱性磷酸酶[骨ALP]，I型胶原蛋白的完整N端前肽和I型胶原蛋白的C端交联端肽）和脊柱和髋关节的BMD，在基线和阿仑膦酸钠或安慰剂治疗1年后。在平均3.6年的随访中，记录了72例髋关节骨折、786例非脊柱骨折和336例椎体骨折。（比值比0.74; CI：0.63，0.87），非脊柱骨折（相对危险度[RH] = 0.89; CI：0.78 1.00; p < 0.050）和髋部骨折（RH 0.61; CI：0.46，0.78）。阿仑膦酸钠治疗的女性，骨ALP至少降低30%，与骨ALP降低的女性相比，非脊柱骨折（RH = 0.72; CI：0.55，0.92）和髋部骨折（RH = 0.26; CI：0.08，0.83）的风险较低
We used data from the Fracture Intervention Trial to assess the relationship change in bone turnover after 1 year of alendronate or placebo treatment and subsequent hip, non-spine, and spine fracture risk among 6186 postmenopausal women. In the alendronate group (n = 3105), greater reductions in one or more biochemical marker were associated with a lower risk of fracture.Introduction: There are few data on the relationship between short-term change in biochemical markers of bone turnover and non-spine fracture risk among bisphosphonate-treated women, and the clinical use of such measurements is unknown.Materials and Methods: We measured biochemical markers of bone turnover (bone-specific alkaline phosphatase [bone ALP], intact N-terminal propeptide of type I collagen, and C-terminal crosslinked telopeptide of type I collagen) and BMD of the spine and hip at baseline and after I year of alendronate or placebo. During a mean follow-up of 3.6 years, 72 hip, 786 non-spine, and 336 vertebral fractures were documented.Results and Conclusions: Each 1 SD reduction in 1-year change in bone ALP was associated with fewer spine (odds ratio 0.74; CI: 0.63, 0.87), non-spine (relative hazard [RH] = 0.89; CI: 0.78 1.00; p < 0.050), and hip fractures (RH 0.61; Cl: 0.46, 0.78). Alendronate-treated women with at least a 30% reduction in bone ALP had a lower risk of non-spine (RH = 0.72; Cl: 0.55, 0.92) and hip fractures (RH = 0.26; Cl: 0.08, 0.83) relative to those with reductions