双释放皮对骨代谢在初级和二级上腺功能衰竭的影响:一项为期6年的研究
Valeria Hasenmajer1, Davide Ferrari1, Dario De Alcubierre1,2
1Department of Experimental Medicine, "Sapienza" University of Rome, Rome 00161, Italy.
Journal of the Endocrine Society
|December 13, 2023
概括
对于上腺功能不全 (PAI和SAI) 的双释放皮松 (DR-HC) 替代疗法,在六年内维持了骨矿物质密度和骨标记物. 骨微架构的衰退与年龄有关,而不是由于DR-HC,证实了其对骨健康的安全性.
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:
- 上腺功能衰竭 (PAI和SAI) 与骨代谢变化有关,可能是由于葡萄糖皮质激素替代疗法.
- 双释放皮 (DR-HC) 是有前途的,但其对骨健康的长期影响需要进一步研究.
研究的目的:
- 评估每天一次的DR-HC对原发性 (PAI) 和二次性上腺功能缺陷 (SAI) 患者的骨代谢的长期影响.
主要方法:
- 患者从即时释放型葡萄皮质类药物转换为相当于DR-HC剂量的患者.
- 评估了骨周转标记,部和腰椎的骨矿物密度 (BMD),以及长达6年的椎骨分数 (TBS).
- 将基线数据与切换到DR-HC后进行的测量进行了比较.
主要成果:
- 在DR-HC治疗6年后,没有观察到骨质量显著变化.
- TBS呈现下降趋势 (P = .090),可能与年龄有关,特别是在女性中.
- 骨循环标志物保持稳定,骨质卡尔辛水平的变化.
结论:
- 慢性DR-HC替代疗法对PAI和SAI患者的骨健康是安全的.
- 观察到的TBS下降可能是由于与年龄相关的骨微观结构变化,而不是葡萄糖皮质激素治疗.
- 在上腺功能不充分的情况下,DR-HC有效地维持BMD和骨标记物.
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