Long-term risedronate treatment normalizes mineralization and continues to preserve trabecular architecture: Sequential triple biopsy studies with micro-computed tomography
Long-term risedronate treatment normalizes mineralization and continues to preserve trabecular architecture: Sequential triple biopsy studies with micro-computed tomography
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DOI：
10.1016/j.bone.2006.01.161
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发表时间：
2006-08-01
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;Dufresne, TE;Turner, RT
该研究的目的是使用接受长期利塞膦酸盐治疗的绝经后骨质疏松症 (PMO) 女性的连续三次活检来评估骨矿化和结构变化的时间过程。在基线时以及每日 5 mg 利塞膦酸盐治疗 3 和 5 年后，从相同受试者 (n = 7) 中获取经髂活检。使用 3 维 (3D) 微型计算机断层扫描 (CT) 和同步辐射测量矿化情况，并与健康绝经前女性 (n = 12) 的水平进行比较。与基线时未经治疗的 PMO 女性相比，绝经前女性的平均矿化度 (Avg-MIN) 和峰值矿化度 (Peak-MIN) 分别高 5.8% (P = 0.003) 和 8.0% (P = 0.003)，低矿化骨量与高矿化骨量 (BMR-V) 和表面积 (BMR-S) 的比率低 73.3% (P 0.005) 和 61.7% （P = 0.003）。相对于基线，利塞膦酸盐治疗 3 年显着增加 Avg-MIN（4.9 +/- 1.1%，P = 0.016）和 Peak-MIN（6.2 +/- 1.5%，P = 0.016），并显着降低 BMR-V（-68.4 +/- 7.3%，P = 0.016）和 BMR-S（-50.2 +/- 5.7%，P） = 0.016) 在 PMO 中 女性。当治疗持续长达 5 年时，这些变化保持在相同水平。这些结果与 3 年治疗后观察到的营业额显着减少一致，并且在 5 年治疗期间也同样保持不变。治疗3年后，利塞膦酸盐使矿化程度以及低矿化骨与高矿化骨的比率恢复至绝经前水平，表明治疗将PMO女性的骨转换降低至健康绝经前水平。传统的显微 CT 分析进一步表明，在治疗长达 5 年的时间内，骨量 (BV/TV) 和小梁结构与基线相比没有变化，这表明利塞膦酸盐可以长期保存 PMO 女性的小梁结构。总体而言，利塞膦酸盐对矿化和结构（骨强度的两个关键决定因素）提供了持续的益处，超过 5 年的时间为其降低骨折风险的长期功效提供了支持。 (c) 2006 Elsevier Inc. 保留所有权利。
The objective of the study was to assess the time course of changes in bone mineralization and architecture using sequential triple biopsies from women with postmenopausal osteoporosis (PMO) who received long-term treatment with risedronate. Transiliac biopsies were obtained from the same subjects (n = 7) at baseline and after 3 and 5 years of treatment with 5 mg daily risedronate. Mineralization was measured using 3-dimensional (3D) micro-computed tomography (CT) with synchrotron radiation and was compared to levels in healthy premenopausal women (n = 12). Compared to the untreated PMO women at baseline, the premenopausal women had higher average mineralization (Avg-MIN) and peak mineralization (Peak-MIN) by 5.8% (P = 0.003) and 8.0% (P = 0.003), respectively, and lower ratio of low to high-mineralized bone volume (BMR-V) and surface area (BMR-S) by 73.3% (P 0.005) and 61.7% (P = 0.003), respectively. Relative to baseline, 3 years of risedronate treatment significantly increased Avg-MIN (4.9 +/- 1.1%, P = 0.016) and Peak-MIN (6.2 +/- 1.5%, P = 0.016), and significantly decreased BMR-V (-68.4 +/- 7.3%, P = 0.016) and BMR-S (-50.2 +/- 5.7%, P = 0.016) in the PMO women. The changes were maintained at the same level when treatment was continued up to 5 years. These results are consistent with the significant reduction of turnover observed after 3 years of treatment and which was similarly maintained through 5 years of treatment. Risedronate restored the degree of mineralization and the ratios of low- to high-mineralized bone to premenopausal levels after 3 years of treatment, suggesting that treatment reduced bone turnover in PMO women to healthy premenopausal levels. Conventional micro-CT analysis further demonstrated that bone volume (BV/TV) and trabecular architecture did not change from baseline up to 5 years of treatment, suggesting that risedronate provided long-term preservation of trabecular architecture in the PMO women. Overall, risedronate provided sustained benefits on mineralization and architecture, two key determinants of bone strength, over 5 years lending support for its long-term efficacy in fracture risk reduction. (c) 2006 Elsevier Inc. All rights reserved.