Efficacy and tolerability of alendronate once weekly in Asian postmenopausal osteoporotic women

BACKGROUND: Osteoporosis has become a major health problem worldwide, and the incidence is rising in Asian countries. The aminobisphosphonates are potent inhibitors of bone resorption and are currently the mainstay of treatment for postmenopausal osteoporosis. Dosing frequency will likely affect tolerability and adherence to treatment. OBJECTIVE: To assess the tolerability and efficacy of a once-weekly aminobisphosphonate preparation in improving bone mineral density (BMD) and bone turnover markers in osteoporotic Asian women. METHODS: Chinese postmenopausal women with osteoporosis were randomized to receive either alendronate 70 mg once weekly plus calcium carbonate 500 mg daily (n = 29) or calcium carbonate 500 mg daily (n = 29) for one year. BMD was measured by dual energy X-ray absorptiometry. Markers of bone formation and bone resorption included plasma total alkaline phosphatase and urine N-telopeptides. RESULTS: Treatment with alendronate 70 mg once weekly for one year resulted in significant BMD improvement of 6.1% at the spine, 5.6% at the femoral neck, and 3.5% at the total hip. There was no significant change in the BMD values in the calcium group (spine 1.4%, femoral neck -0.2%, total hip 0%). The BMD response in the alendronate group was significantly different from that in the calcium group at all time points, and the difference was detectable as early as after 3 months of treatment (ANOVA p < 0.001). The changes remained significant after adjusting for age, age at menarche, and years since menopause (p < 0.001). Similarly, the reductions in bone markers at 12 months were significantly different between the 2 treatment groups (plasma total alkaline phosphatase: alendronate 27.9%, calcium 5.4%; urine N-telopeptide: alendronate 55.6%, calcium 11.2%; both p < 0.001). The alendronate regimen was well tolerated, without significant adverse events. CONCLUSIONS: The results confirmed that once-weekly alendronate was efficacious in increasing BMD and reducing bone turnover and was well tolerated in Asian women.     

碳酸钙D3咀嚼片联合唑来膦酸注射液治疗老年男性骨质疏松症的临床效果

目的分析碳酸钙D3咀嚼片联合唑来膦酸注射液治疗老年男性骨质疏松症的临床效果。方法回顾性选取本院2018年1月至2020年1月收治的100例老年男性骨质疏松症患者的临床资料,依据治疗方法将其分为联合治疗组(50例,碳酸钙D3咀嚼片联合唑来膦酸注射液治疗)和单独治疗组(50例,单独碳酸钙D3咀嚼片治疗)。比较两组患者的血钙、血磷、骨代谢相关生化指标水平、骨密度、临床疗效及不良反应发生情况。结果治疗后,两组的血钙、血磷、BGP、BAP水平均升高,β-CTX、TRAP-5b水平均降低,且联合治疗组明显优于单独治疗组(P<0.05)。治疗后,联合治疗组腰椎L_2~4、股骨颈、股骨大转子、Ward三角区的骨密度均明显高于单独治疗组(P<0.05)。联合治疗组的治疗总有效率为94.00%,明显高于单独治疗组的80.00%(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论碳酸钙D3咀嚼片联合唑来膦酸注射液治疗老年男性骨质疏松症的临床效果显著,且安全性高。     

利维爱对绝经后妇女骨密度及骨代谢指标的影响

目的了解利维爱对绝经后妇女骨密度及骨代谢指标的影响 . 方法将 123例自然绝经后妇女随机分 2组 研究组每日口服利维爱 1.25 mg+ 钙尔奇 D 600 mg, 对照组每日口服钙尔奇 D 600 mg, 观察 12个月 . 用药前后分别检测腰椎 (L 2～ 4)及股骨颈 (NK)骨密度 (BMD)骨代谢指标血清骨钙素 (BGP)和碱性磷酸酶 (AKP)及尿吡啶酚 /肌酐 (Pyr/cr)和钙 /肌酐 (Ca/Cr)比值 . 结果 (1)L 2～ 4、 NK两部位 BMD 研究组治疗后均增加 , 且前者上升有显著性差异 (P< 0.05);对照组均下降无显著性差异 (P >0.05);治疗后 2组间比较有显著性差异 (P< 0.01,P< 0.05). (2)生化指标血 BGP、 AKP及尿 Pyr/Cr、 Ca/Cr 治疗后研究组均上升有显著性差异 (P< 0.01,P< 0.05); 对照组变化无显著性差异 (P >0.05). 结论绝经后妇女每日服用 1.25 mg利维爱加钙尔奇 D可以提高骨量 ; 单用钙尔奇 D不能防止骨丢失 .     

老年男性骨质疏松与相关影响因素的关系

INTRODUCTIONOsteoporosisisacommondiseaseintheoldpeople.Theincidenceofosteoporosisinmenislaterthaninwomen,andthemorbidityislower,sothestudyonthemaleosteoporosisseemstobedefi-cient.Butsomeinvestigationdatashowthatalmostone-thirdofallhipfracturesworldwideoccurinmen.Themortalityinmenisevidenthigherthaninwomenofthesameage犤1-2犦.Itisveryimportanttostudymoreissuesofmaleosteoporosis.Inordertosurveyitspathogeny,wemeasurethebonemineraldensityin97oldmenbydualenergyX-rayabsorptiometry(DEXA).Atthe…     

Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial

AIM: To investigate efficacy, tolerance and safety of the drug vitrum osteomag one tablet of which contains 600 mg calcium (1500 mg calcium carbonate), 200 IU of cholecalcepherol, 40 mg of magnesium, zinc (7.5 mg), copper (1 mg), manganese (1.8 mg) and boron (250 mcg) in women with osteopenia for prevention of osteoporosis. MATERIAL AND METHODS: A multicenter comparative open trial of vitrum osteomag influence on mineral bone density (MBD), change of pain syndrome in bones, index of calcium-phosphorous metabolism covered 334 postmenopausal women with osteopenia. MBD was measured in low-back spine and proximal part of the hip with DEXA method. All the patients were divided into 3 groups: 125 women taking 2 tablets of vitrum osteomag daily for 12 months (group 1); 111 women taking 1500 mg calcium carbonate (group 2); 96 women--control group (only observation). RESULTS: Vitrum osteomag relieved pain in the back and joints, had a positive effect on bone density (+1.5%) and proximal parts of the hip (0.6-0.93%) exceeding the effect of calcium carbonate only which preserves the initial MBD in low back spine but does not prevent bone loss in the hip. MBD dynamics in patients given vitrum osteomag differs essentially from one in the control group (from -1.9 to -2.91%) which demonstrates a reliable preventive anti-osteoporotic effect of this medication. The drug increases the level of general and ionized calcium in blood but does not cause hypercalcemia lowering the level of parathormone in blood. The rate of side effects in group 1 was 14.4% and did not differ much from that in group 2 (16.2%). CONCLUSION: The results of the study allow to recommend vitrum osteomag for prophylaxis of a rapid loss of bone tissue mineral density.     

阿仑膦酸钠治疗绝经后妇女骨质疏松症的临床观察

目的探讨阿仑膦酸钠增加绝经后妇女骨密度,降低骨折的疗效。方法陕西省人民医院老年病门诊及住院患者,用简单随机化方法分为研究组和对照组。研究疗程为12个月,在治疗前、6个月末和12个月末对阿仑膦酸钠的疗效进行评估。结果本研究共入组60例（碳酸钙组：30例、阿仑膦酸钠组：30例）,在6个月末和12个月末：髋骨的骨密度阿仑膦酸钠组较碳酸钙组明显增高,差异有统计学意义（P〈0．05）。骨钙素测定阿仑膦酸钠组较碳酸钙组明显降低,差异有统计学意义（P〈0．05）。尿I型胶原氨基末端肽／肌酐（NTX／Cr）阿仑膦酸钠组较碳酸钙组明显降低（P〈0．01）。再发骨折率阿仑膦酸钠组（3．33％）较碳酸钙组（16．67％）明显下降（P〈0．01）。结论与碳酸钙对比,阿仑膦酸钠降低骨转换,增加绝经后骨质疏松症患者的骨密度,减少骨折发生率。     

阿仑膦酸盐预防和治疗男性骨质疏松症疗效的系统评价

目的评价阿仑膦酸盐预防和治疗男性骨质疏松症的效果和可能的不良反应。方法电子检索:MEDLINE(1990-2005)、EMBASE(1990-2005)、 Cochrane图书馆临床对照试验资料库(2005年第3期)、Current Controlled Trials、The National Research Register、中国生物医学义献数据库 (1990-2005)和中文科技期刊全文数据库(1990-2005)、中文学术期刊全文数据库(1990-2005),并手工检索相关领域其他杂志。检索时间截止至2005年11月。所有检索均不受语种限制。纳入以有骨质疏松症高危风险或患骨质疏松症男性为研究对象、比较阿仑膦酸盐与其它疗法疗效的随机对照试验,评价纳入研究的质量,并用RevMan 4．28软件进行Meta分析。结果共纳入7个随机对照试验,包括817例患者。Meta分析结果显示,阿仑膦酸盐 钙剂对提高骨质疏松症高危男性患者腰椎骨密度的作用优于单用钙剂[SMD 0．59,95％CI(0．15,1．03),P=0．009];对于降低骨折风险,阿仑膦酸盐 钙剂与单用钙剂相似;对于降低脊柱骨折的风险,2年以上疗程的阿仑膦酸盐治疗优于α-骨化醇,但是对于非脊椎骨折,两者疗效相似;阿仑膦酸盐提高骨密度的效果优于α-骨化醇、钙剂;在预防骨质疏松症、提高骨密度方面,阿仑膦酸盐不如降钙素、α-骨化醇、甲状旁腺激素;阿仑膦酸盐联合甲状旁腺激素优于单独使用阿仑膦酸盐;阿仑膦酸盐联合甲状旁腺激素与单独使用甲状旁腺激素比较,两者对提高骨密度的疗效相似。结论阿仑膦酸盐预防和治疗男性骨质疏松症的疗效优于钙剂;对于提高骨密度,阿仑膦酸盐不如降钙素、α-骨化醇;长期使用阿仑膦酸盐比α-骨化醇更能减少脊柱骨折的风险。阿仑膦酸盐联合甲状旁腺激素与单用甲状旁腺激素比较,两者在治疗男性骨质疏松症方面的效果相似。今后尚需开展更多高质量特别是多中心研究以增加证据的强度。     

Management of male osteoporosis: report of the UK Consensus Group

Although osteoporosis is generally regarded as a disease of women, up to 30% of hip fractures and 20% of vertebral fractures occur in men. Risk factors for osteoporotic fractures in men include low body mass index, smoking, high alcohol consumption, corticosteroid therapy, physical inactivity, diseases that predispose to low bone mass, and conditions increasing the risk of falls. The key drugs and diseases that definitely produce a decrease in bone mineral density (BMD) and/or an increase in fracture rate in men are long-term corticosteroid use, hypogonadism, alcoholism and transplantation. Age-related bone loss may be a result of declining renal function, vitamin D deficiency, increased parathyroid hormone levels, low serum testosterone levels, low calcium intake and absorption. Osteoporosis can be diagnosed on the basis of radiological assessments of bone mass, or clinically when it becomes symptomatic. Various biochemical markers have been related to bone loss in healthy and osteoporotic men. Their use as diagnostic tools, however, needs further investigation. A practical approach would be to consider a bone density more than one SD below the age-matched mean value (Z < -1) as an indication for therapy. The treatment options for men with osteoporosis include agents to influence bone resorption or formation and specific therapy for any underlying pathological condition. Testosterone treatment increases BMD in hypogonadal men, and is most effective in those whose epiphyses have not closed completely. Bisphosphonates are the treatment of choice in idiopathic osteoporosis, with sodium fluoride and anabolic steroids to be used as alternatives.      

骨肽注射液对维甲酸所致大鼠骨质疏松的治疗作用及其机制

[目的]探讨骨肽注射液对维甲酸所致大鼠骨质疏松的治疗作用及其机制.[方法]50只SD雄性大鼠随机分为正常对照组,模型对照组,骨肽注射液低、中、高剂量组,除正常组外,其余四组均连续2周每天注射70 mg/kg的维甲酸建模.骨肽注射液低、中、高剂量组大鼠灌胃给予100、200、400 μg/(kg·d)的骨肽注射液,正常对照组及模型对照组给予等量生理盐水,连续给药4周.观察并记录大鼠骨质量及骨密度,并采用全自动生化分析仪检测血钙、血磷含量及血清碱性磷酸酶(ALP)活性,试剂盒检测血清中抗酒石酸性磷酸酶(TRACP)活性及骨钙素水平.[结果]与正常对照组比较,模型对照组中骨质量,骨密度,血钙及血磷含量均显著降低(P<0.01),ALP及TRACP活性升高(P<0.01),骨钙素含量升高(P<0.01);与模型对照组比较,骨肽注射液低、中、高剂量组中骨质量、骨密度、血钙及血磷含量均明显提高(P<0.01),ALP、TRACP活性降低(P<0.01),骨钙素含量降低(P<0.01).[结论]骨肽注射液对维甲酸所致的大鼠骨质疏松具有一定的治疗作用,其机制与其调节骨代谢有关.     

Bone turnover markers and sex hormones in men with idiopathic osteoporosis

BACKGROUND: In contrast to osteoporosis in postmenopausal women, osteoporosis in men has received much less attention. PATIENTS AND METHODS: We determined various biochemical parameters of bone metabolism and sex hormones in 31 men with idiopathic osteoporosis and 35 age matched control subjects. RESULTS: In the men with osteoporosis, a significantly increased urinary excretion of deoxypyridinoline (5.3 +/- 0.2 vs. 4.6 +/- 0.2 nmol mmol-1 creatinine; P = 0.033) in addition to increased serum levels of the c-terminal telopeptide of type I collagen (2677 +/- 230 vs. 2058 +/- 153 pmol; P = 0.037) were found. While parameters of bone formation were not significantly different in the patients and controls, serum bone sialoprotein levels were significantly decreased in the patients (3.7 +/- 0.8 vs. 12.4 +/- 4.0 ng mL-1; P = 0.021). Moreover, in men with idiopathic osteoporosis, lower levels of estradiol (91.3 +/- 5.8 vs. 114.6 +/- 7.8 pmol L-1; P = 0.044), higher levels of sex hormone binding globulin (31.5 +/- 3.1 vs. 24.2 +/- 1.4 nmol L-1; P = 0.034) and a decreased free androgen index (42.6 +/- 5.2 vs. 56.4 +/- 5.9; P = 0.016) were seen. Serum estradiol levels correlated negatively with several parameters of bone resorption. CONCLUSIONS: In men with idiopathic osteoporosis, bone resorption is increased and exceeds bone formation. The excessive bone resorption seen in idiopathic male osteoporosis may be due to decreased estradiol levels and low levels of bioavailable testosterone.     

Osteoporosis: part II. Nonpharmacologic and pharmacologic treatment

Family physicians will frequently encounter patients with osteoporosis, a condition that is often asymptomatic until a fracture occurs. Treatment of the fracture can be initiated without further diagnostic testing. Thereafter, treatment of osteoporosis includes (1) prevention of further bone loss through weight-bearing exercise, tobacco and alcohol avoidance, hormone replacement therapy in women, and raloxifene and calcium supplementation; (2) treatment of fracture-related pain with analgesics and calcitonin; (3) building bone mass when feasible with alendronate; and (4) modifying behaviors that increase the risk of falls. Patients without fracture who are at risk for osteoporosis can also benefit from these preventive measures. Furthermore, women of all ages should be encouraged to maintain a daily calcium intake of 1,000 to 1,500 mg and to participate in weight-bearing exercise for 30 minutes three times weekly to reduce their risk of falls and fractures. Persons at risk should avoid medications known to compromise bone density, such as glucocorticoids, thyroid hormones and chronic heparin therapy.     

运动联合碳酸钙维生素D对绝经早期女性骨标志物的影响

目的探讨运动联合碳酸钙维生素D在预防绝经早期女性骨质疏松的疗效观察。方法选择100例绝经早期女性,分为试验组和对照组各50例,分别进行X线骨密度(BMD)检测和3种骨标志物检测,作为基线。试验组给予碳酸钙维生素D3片口服,连续3、6、12、18个月后再次检测BMD和骨标志物,观察各指标的变化情况。结果绝经早期女性均存在较高的骨代谢转换率。运动联合碳酸钙维生素D治疗,可显著影响3种骨标志物的水平,3种骨标志物与BMD呈负相关,而且骨转换指标的改变优先于BMD。试验组3种骨标志物3个月内已发生变化,分别下降25%、12%、10%。在监测碳酸钙维生素D对骨标志物影响时,3种骨标志物各具有不同特点。Ⅰ型前胶原羧基端肽B特殊序列(β-CTX)在早期3个月内即可显著下降,6个月后基本变化不明显;Ⅰ型前胶原氨基端延长肽(P1NP)和N端骨钙素(N-MID)反应时间较长,在抗重吸收6个月后才有明显变化,1年后基本维持在一定水平,而BMD的改变则至少需要12个月以上。结论坚持运动和持续补充碳酸钙维生素D,能有效降低骨骼重吸收和改善维生素D水平,对绝经早期女性预防骨质疏松有重大意义。     

甲状腺功能亢进对骨代谢影响

目的 研究甲状腺功能亢进(甲亢)患者骨代谢生化指标与骨密度(BMD)之间的关系,探讨甲亢性骨病发生机制.方法 随机选择甲亢患者116例,按BMD测定结果分为骨量正常组61例,骨密度减低组39例,骨质疏松组16例.分别测定患者血清钙、磷、镁、碱性磷酸酶(ALP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)以及24小时尿钙、磷、镁,比较3组之间的差异.结果 甲亢骨量正常组血FT4、AIP、尿镁显著低于骨量减低组及骨质疏松组,而血镁显著高于骨量减低组及骨质疏松组(P＜0.05),女性患者所测部位骨密度均显著低于男性患者(P＜0.01).相关分析显示,FT4、ALP与各部位骨密度呈负相关,血镁与各部位骨密度呈正相关,尿镁与FT3、尿钙之间呈正相关.结论 甲亢患者可出现不同程度的骨代谢异常,在治疗甲亢的同时,应积极防治甲亢性骨病的发生.     

老年人骨质疏松与动脉硬化的关系

目的通过对骨密度与冠状动脉钙化积分、颈动脉内中膜厚度及斑块关系的分析, 探讨骨质疏松与动脉硬化的关系.方法对66例老年冠心病、高血压或脑动脉硬化患者行双能X线骨密度仪测定腰椎、髋部、前臂的骨密度, 螺旋CT检测冠状动脉钙化积分及冠状动脉总钙化积分, 颈动脉超声检测颈动脉内中膜厚度及斑块,测定血甲状旁腺激素全段、骨钙素、血钙.据骨密度分骨质疏松组(A组),非骨质疏松组(B组).结果 A组患者的冠状动脉各分支钙化积分及冠状动脉总钙化积分、颈动脉内中膜厚度、颈动脉多发性硬斑发生率高于B组(P<0.01).冠状动脉钙化积分、颈动脉内中膜厚度与甲状旁腺激素呈正相关,与骨钙素、血钙呈负相关, 与各部位的骨密度呈负相关.结论骨质疏松症与动脉硬化有密切的关系, 骨质疏松时钙从骨中溶出增加,体循环中的钙可异常沉积在血管内膜中,造成血管壁动脉粥样硬化、钙化.     

单一钙制剂与钙制剂联合维生素D干预治疗老年男性骨质疏松症疗效的随机对照临床研究

目的探讨单一钙制剂和钙制剂联合维生素D(Vd)治疗老年骨质疏松的疗效。方法共纳入380例男性老年骨质疏松症患者,随机分为单纯补钙组(单一钙制剂)和联合补钙组(钙制剂+Vd),各190例,观察治疗前和治疗后个体的骨密度和骨质疏松各项指标。结果在治疗3个月后,两组老年患者中全身腰椎2~4、股骨颈和大转子部位的骨密度(BMD)均有所增加,其中Vd+钙制剂组中各BMD与干预前相比有显著性差异(P0.05)。在6个月末两组之间BMD无显著差异,血清羟脯氨酸水平在Vd+钙组中显著降低(P0.05)。结论补充适宜的钙和Vd对于按男性老年骨质疏松的预防有一定作用,单纯补钙不如同时补充钙和Vd对体成分和BMD的改善效果明显。补钙的同时服用Vd可以显著提升体内的Vd水平和短期内骨组织的密度,预防老年人的骨钙流失。     

老年骨质疏松症现状及进展

老年性骨质疏松症以骨矿含量下降,骨微细结构破坏为病理特征。男性峰值骨量高于女性,出现骨丢失的年龄迟于女性,而且雄激素水平的下降是“渐进式”,而非“断崖式”,故老年男性骨丢失的量与速度都低于老年女性,老年男性骨质疏松的程度轻于女性。老年骨质疏松症的诊断基于全面的病史采集、体格检查、骨密度测定、影像学检查(X线及QCT)及必要的生化测定。在使用基础用药的基础上(钙剂和维生素D),治疗骨质疏松症的药物可分为抑制骨吸收药物和促骨形成药物。抑制骨吸收药物包括双膦酸盐、雌激素替代疗法、选择性雌激素受体调节剂(SERM)、地舒单抗、降钙素等等。促骨形成药物包括甲状旁腺激素(PTH)类似物和骨硬化蛋白抑制剂。序贯和组合使用抗骨质疏松药物,例如从促骨形成药物转换为抑制骨吸收药物,可能提高抗骨质疏松疗效。该文将总结老年性骨质疏松症的流行病特点、分子机制、诊断、目前治疗骨质疏松症的药物及联合或序贯用药策略。     

Treatment of osteoporosis. What is the role of calcium?

On the basis of currently available information, the following recommendations can be made for treating osteoporosis. Women with no contraindications should maintain a total calcium intake of 1,000 mg daily before menopause and 1,500 mg daily after menopause. Calcium supplementation should be considered adjunct treatment in postmenopausal women and those who already have osteoporosis. At menopause, women with no contraindications should be given the option of taking estrogen to prevent osteoporosis. Vitamin D supplementation up to the recommended dietary allowance should be used in patients who may not get adequate dietary intake or sunlight exposure. Calcium carbonate should be the main calcium supplement when possible, because it is usually the least expensive and has the highest percentage of calcium. In older patients, who may have achlorhydria, calcium carbonate should be taken with food or another form of calcium that is well absorbed should be used. In compliant patients, calcium supplements should be given in two or three divided doses. Until more is known about exercise and osteoporosis, low-intensity exercise that promotes cardiovascular fitness should be prescribed. One appropriate regimen is brisk walking for 1 hour three times a week.     

唑来膦酸治疗老年男性原发性骨质疏松的临床效果评估

【目的】评估唑来膦酸治疗老年男性原发性骨质疏松患者的临床效果。【方法】将76名年龄≥70岁的男性原发性骨质疏松患者随机分为两组。对照组（n＝39）每日补充钙剂和维生素D,治疗组（n＝37）在对照组的基础上给予一次静脉滴注唑来膦酸5 mg。随访12个月后观察所有研究对象骨密度和骨代谢标记物水平变化。【结果】治疗组的椎骨、全髋骨和股骨颈骨密度均显著高于对照组（P＜0．05）;血液骨代谢标记物β-CTx、PINP和BSAP水平则显著低于对照组（P ＜0．05）,两组严重不良反应发生率分别为24．32％和23．08％,差异无统计学意义（P＞0．05）。【结论】唑来膦酸治疗一年后可以显著提高患者骨密度和降低骨代谢标记物水平,降低老年男性原发性骨质疏松患者的骨折危险。     

Potential use of biochemical markers of bone turnover for assessing the effect of calcium supplementation and predicting fracture risk

BACKGROUND: Biochemical markers of bone remodeling have been extensively used (independent of bone mass measurements) to document the efficacy of various anticatabolic and anabolic bone-modifying medications in reducing fracture risk. Nonetheless, their usefulness in determining the effectiveness of osteoporosis prevention and treatment, particularly calcium supplementation, has not been well established. OBJECTIVE: This article reviews the use of biochemical markers of bone remodeling as a measure of the effect of calcium supplementation and the implications for prediction of fracture risk. METHODS: A generalized search of MEDLINE from 1966 through April 2004 using the terms osteoporosis, fracture risk, and the specific bone biomarkers of interest was conducted to identify articles relating to these biomarkers and their relationship to prediction of fracture risk. A second MEDLINE search for the same period used the terms calcium, biological markers, and fracture risk to identify studies of calcium supplementation and bone biomarkers. In both cases, the reference lists of identified review articles were searched for additional publications. RESULTS:: Several biochemical markers of bone remodeling have been shown to be positively correlated with bone mineral density and fracture risk. Furthermore, calcium supplementation has been shown to have a significant correlation with levels of a number of these biomarkers (P < 0.05): the markers of bone formation procollagen type I carboxy and amino terminal peptides and serum bone-specific alkaline phosphatase, and the markers of bone resorption urinary hydroxyproline, urinary pyridinoline, urinary deoxypyridinoline, urinary amino terminal crosslinked telopeptide, and urinary and serum carboxy terminal crosslinked telopeptide. CONCLUSIONS: Calcium supplementation has a significant effect on a number of biomarkers of bone remodeling, an effect that is, in turn, correlated with decreased fracture risk. Most studies of the efficacy of calcium supplementation in reducing bone remodeling and influencing bone mineral density and fracture risk have involved calcium carbonate, although a few studies have found that other calcium salts may produce similar results.     

雌激素与葛根素组合治疗去卵巢大鼠骨症的最佳剂量

背景:小剂量的葛根素联合雌二醇对去卵巢大鼠骨质疏松症的治疗效果与单独使用较大剂量的葛根素或较大剂量的雌二醇效果相近。目的:寻找治疗Ⅰ型骨质疏松症最佳的雌二醇和葛根素的剂量搭配。方法:64只健康雌性大白鼠等分为假手术组、去卵巢模型组、葛根素-50组、雌二醇-200组、葛根素+雌二醇-5,50,100,150组。除假手术组外,其余大鼠均建立去卵巢动物模型。葛根素-50组大鼠皮下注射葛根素50mg/kg,1次/d;雌二醇-200组大鼠皮下注射雌二醇200μg/kg,2次/周;葛根素+雌二醇-5,50,100,150组大鼠皮下注射葛根素25mg/kg,1次/d同时分别注射雌二醇5,50,100,150μg/kg,2次/周。结果与结论:去卵巢模型组大鼠骨密度和骨钙、骨磷水平明显低于假手术组(P<0.05),骨组织呈骨质疏松的病理改变;葛根素和/或雌二醇治疗10,20周后骨密度和骨钙、骨磷水平明显升高(P<0.05),其中葛根素+雌二醇-100组治疗去卵巢大鼠骨质疏松的效果最为明显,提示葛根素25mg/kg,1次/d+雌二醇100μg/kg,2次/周是治疗去卵巢大鼠骨质疏松的最佳搭配剂量。