在接受阿迪森病葡萄糖皮质类替代药物治疗的患者中,骨矿物质密度的预测因素
Katarzyna Furman1,2, Paweł Gut1, Anna Sowińska3
1Department of Endocrinology, Metabolism and Internal Medicine, Poznań University of Medical Sciences, Poznań, Poland.
Endocrine
|February 9, 2024
概括
对阿迪森病的标准皮治疗没有显著加快骨矿物质密度的损失. 在葡萄糖皮质醇替代期间,建议监测性酸酶,CTX和硬质素等骨循环标记物.
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
- 矿物质皮质类皮质缺乏症
背景情况:
- 长期使用葡萄糖皮质激素 (GC) 治疗会造成骨质疏松症的风险.
- 在阿迪森病 (AD) 中,GC替代剂对骨的影响尚未得到充分证实.
研究的目的:
- 评估血清骨循环标记 (BTMs) 和它们与骨矿物质密度 (BMD) 的关系,在接受皮 (HC) 替代疗法的AD患者中.
- 评估特定的BTM,包括骨质素,PINP,CTX,硬质素,DKK-1和性酸酶 (ALP).
主要方法:
- 血清BTM和荷尔蒙被测量在80个AD患者在HC≥3年.
- 骨矿物质密度 (BMD) 在腰椎 (LS) 和大腿部 (FN) 用双能X射线吸收计进行评估.
主要成果:
- 在AD患者的BTM中,只有PINP水平显著改变.
- BMD Z-分数通常为负,骨质疏松症和骨质疏松症在患者群体中普遍存在.
- 腰部BMD与HC剂量,年龄,疾病持续时间,ALP活性和CTX水平有负相关性,但与体重和DHEA-S有积极相关性.
结论:
- 标准的HC替代疗法似乎不会显著加速AD患者的BMD损失.
- 血清BTM如CTX,骨素,硬质素,DKK-1和ALP活动一般保持在参考范围内.
- 低LS BMD的独立预测因素,包括ALP活性,血清CTX和硬质素,在GC替代期间需要监测.
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