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Treatment of postmenopausal osteoporosis with recombinant human parathyroid hormone and electromagnetic field
Miao Xuan1, Bo Wang2, Wanrong Bi3
1Department of Endocrinology,School of Medicine，Tongji Hospital, Tongji University, Shanghai, 200065, China.
Objective:
This study aimed to investigate the effect of electromagnetic field (EMF) combined with recombinant human parathyroid hormone (rhPTH) on bone mineral density (BMD) and bone turnover indicators in postmenopausal osteoporosis (PMOP) patients.
Methods:
A total of 336 PMOP patients were randomly assigned into three groups: EMF + rhPTH group (n = 115), rhPTHx group (n = 113) and EMF group (n = 108). The lumbar spine and femoral neck BMDs were measured before treatment and at 6, 12, and 18 months after treatment. Blood calcium, bone alkaline phosphatase (BSAP), type I procollagen N-terminal peptide (PINP), and type I collagen C-terminal peptide/creatinine ratio (CTX/Cr) levels were measured before treatment and at 3, 6, 12, and 18 months after treatment.
Results:
The lumbar spine BMD was significantly increased at 6, 12, and 18 months after treatment, and the neck BMD was increased markedly at 18 months in both EMF + rhPTH group and rhPTH group as compared to those before treatment. There was significant difference in the lumbar spine BMD between EMF + rhPTH group and EMF group and between rhPTH group and EMF group at 6, 12, and 18 months after treatment. In the EMF + rhPTH group, at 3, 6, 12, and 18 months after treatment, blood calcium level was increased by 5.2%, 2.8%, 2.7%, and 3.1%, respectively; BASP level was increased by 80.9%, 120.3%, 84.1%, and 67.7%, respectively; PINP level was increased by 65.4%, 79.7%, 89.7%, and 74.5%, respectively; CTX/Cr was increased by 80.9%, 120.3%, 84.1%, and 67.7%, respectively; the bone metabolism indicators were markedly higher than those before treatment. In the rhPTH group, at 3, 6, 12, and 18 months after treatment, blood calcium level was increased by 5.1%, 3.3%, 3.0%, and 2.1%, respectively; BSAP level was increased by 51.6%, 81.4%, 101.1% and 56.3% respectively; PINP level was increased by 48.5%, 69.8%, 80.7% and 70.5% respectively; CTX/Cr was increased by 29.8%, 29.9%, 55.7%, and 44.8% respectively; the bone turnover indicators were significantly different from those before treatment (P < 0.01).
Conclusion:
The combination of EMF and rhPTH can significantly improve the bone turnover and BMD of PMOP patients, and may serve as a clinical treatment of PMOP.
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