停产前异常性骨质疏松症的连续治疗后的骨密度和重塑
Adi Cohen1, Mafo Kamanda-Kosseh2, Ragyie Rawal2
1Columbia University Irving Medical Center, New York, NY, USA. ac1044@columbia.edu.
概括
连续治疗骨质疏松症的teriparatide-denosumab和双酸盐增加了在绝经前妇女的骨矿物质密度 (BMD). 停止使用双酸盐后发生骨质损失,需要对一些人进行重新治疗,尽管BMD仍然高于基线.
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
- 骨质疏松症研究 骨质疏松症研究
背景情况:
- 在更年期前妇女的异常性骨质疏松症 (IOP) 提出了独特的治疗挑战.
- 连续治疗teriparatide,其次是denosumab,表明骨矿物质密度 (BMD) 显著增加.
- 在一项先前的研究中,在停止使用德诺苏马布后,一年的双酸盐治疗维持了BMD的增加.
研究的目的:
- 为了评估在连续的特里巴胺-德诺苏马布治疗后的BMD增长的持久性.
- 在IOP的绝经前妇女接受双酸盐治疗后,在1年停疗期间评估BMD变化.
主要方法:
- 参与了19名患有IOP的绝经前妇女.
- 骨矿物质密度 (BMD) 用DXA测量,血清CTX水平每6个月评估一次.
- 该研究涉及1年的双酸盐治疗,随后1年的观察治疗.
主要成果:
- 连续的特里巴-登苏马布增加了脊椎BMD的23%,部BMD的12%.
- 双酸盐治疗维持了BMD和抑制了骨复吸标记 (CTX) 一年.
- 在非治疗一年内,骨质量显著下降 (脊椎:4.2%,部:1.4%),CTX增加,促使10名参与者重新接受治疗.
- 尽管有骨质损失,在研究结束时,BMD仍然明显高于治疗前的水平.
结论:
- 连续的teriparatide-denosumab治疗,其次是1年的双酸盐,有效地增加并维持了IOP的绝经前妇女的BMD.
- 停止使用双酸盐导致骨质流失和骨周转率增加,这表明需要仔细监测.
- 需要进行进一步的研究,以确定在这个人群中停止使用德诺苏马布后,双酸盐治疗的最佳持续时间.
相关概念视频
01:40Bone Remodeling
40.2K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
40.2K
01:29Bone Disorders
5.0K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
5.0K
01:31Osteoclasts in Bone Remodeling
3.8K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
3.8K
01:17Hormones and Bone Tissue
3.6K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
3.6K
01:25Role of Vitamins in Maintaining Bone Health
5.0K
The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
5.0K