TREATMENT FOR OSTEOPOROSIS OF THE HIP

髋部骨质疏松症的治疗

• 批准号: 2051626
• 负责人: John CHRISTOPHER GALLAGHER
• 金额: $ 67.47万
• 依托单位: CREIGHTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1996-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2051626
• 关键词: 1,25 dihydroxycholecalciferol; blood chemistry; bone density; calcium metabolism; caucasian American; clinical trials; dietary calcium; disease /disorder proneness /risk; drug adverse effect; estrogens; female; femur; hip fractures; hormone therapy; human old age (65+); human subject; human tissue; interview; longitudinal human study; malabsorption; nutrition related tag; osteoporosis; photon absorptiometry; physiologic bone resorption; placebos; postmenopause; progestins; skeletal disorder chemotherapy; spine; urinalysis

Bone loss from the proximal femur continues into the nineties and low bone mass leads to an increased susceptibility to fracture. The risk of fracture accelerates between age 80-90 so that 33% of women and 17% of men sustain a hip fracture. Hip fractures cause an immediate 15% mortality, and will cost 20 billion dollars annually within 20 years. Two major factors play a role in the bone loss. Estrogen deficiency after the menopause is associated with increased bone loss from the femur. In the mid sixties a second factor emerges - malabsorption of calcium, which increases the degree of negative calcium balance causing secondary hyperparathyroidism and bone loss. By correcting estrogen deficiency and malabsorption of calcium it may be possible to reverse bone loss from the proximal femur. In order to test this hypothesis, 500 osteopenic women aged between 65-77 years will be treated with either estrogen, 1 alpha- hydroxyvitamin D2 (1 alpha-OH-D2) or a combination of estrogen and 1 alpha- OH-D2 for 3 years in an attempt to reverse bone loss from the proximal femur. It is suggested that estrogen will inhibit bone resorption and 1 alpha-OH-D2 will stimulate bone formation, and that the combination will be more effective than single therapy. The study will be double blind and placebo controlled. The primary outcome will be bone mineral density of the proximal femur, however, other areas of the skeleton will be measured so that any effect of therapy which might cause redistribution of bone mineral from cortex to trabecular sites can be detected. Loss of cortical bone could increase fracture susceptibility. Reversing bone loss from the proximal femur from age 65 for several years could maintain bone density above the fracture threshold and significantly reduce the risk of fracture. Not only would this provide considerable individual health benefits, but also greatly reduce health care costs.

股骨近端骨丢失持续到90年代和低骨