在患有自身免疫原发性上腺功能衰竭的患者中,双释放皮的骨安全性
Fabio Bioletto1, Marco Barale1, Mirko Parasiliti-Caprino1
1Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
Frontiers in endocrinology
|September 28, 2023
概括
双释放皮质 (DR-HC) 与常规葡萄皮质类药物 (C-GC) 相比,在上腺功能衰竭 (AI) 患者中改善了骨健康. 与C-GC不同的是,DR-HC降低了骨折风险,并保持了骨矿物质密度.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 药理学 药理学是指药理学的学科.
背景情况:
- 传统的葡萄糖皮质类药物 (C-GC) 对骨健康产生负面影响,并增加上腺功能不足 (AI) 患者骨折风险.
- 新型双释放皮质 (DR-HC) 配方可能会提供更好的安全性,但骨比较数据有限.
研究的目的:
- 为了比较C-GC与DR-HC对自身免疫原发性AI患者骨相关参数的影响.
- 为了评估骨矿物质密度 (BMD),椎骨分数 (TBS),以及两组治疗之间的骨折发生率.
主要方法:
- 一项涉及27名自身免疫原发性AI患者的比较研究.
- 13名患者接受了C-GC,14名患者接受了DR-HC.
- 评估了骨周转标志物,骨维度 (腰椎和大腿部),TBS和脊椎骨折数量.
主要成果:
- 在C-GC和DR-HC组之间没有发现骨循环标记的显著差异.
- 与DR-HC相比,C-GC治疗与显著较低的腰椎和大腿部部BMD相关.
- 接受C-GC治疗的患者患有较低的TBS和较高的脊椎骨折发生率,TBS预测骨折风险.
结论:
- 在初级AI患者中,DR-HC与骨并发症相比C-GC更少.
- TBS是C-GC对骨折风险的有害影响的关键因素,突出了其在评估葡萄糖皮质类药物治疗下骨健康的重要性.
相关概念视频
Adrenal Gland Disorders
1.6K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.6K
Hormones of the Adrenal Glands
2.5K
Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
2.5K
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
144
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
144
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
289
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
289
Hypothalamic-Pituitary Axis
60.4K
The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
60.4K
Anatomy of the Adrenal Glands
2.3K
The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
2.3K


