Osteoporosis International ( IF 4 ) Pub Date : 2022-06-21 , DOI: 10.1007/s00198-022-06457-0 S. E. Bønløkke , M. S. Rand , B. Haddock , S. Arup , C. D. Smith , J. E. B. Jensen , P. Schwarz , P. Hovind , P. S. Oturai , L. T. Jensen , S. Møller , P. Eiken , K. H. Rubin , M. F. Hitz , B. Abrahamsen , N. R. Jørgensen
Summary
Anti-resorptive osteoporosis treatment might be more effective in patients with high bone turnover. In this registry study including clinical data, high pre-treatment bone turnover measured with biochemical markers was correlated with higher bone mineral density increases. Bone turnover markers may be useful tools to identify patients benefitting most from anti-resorptive treatment.
Introduction
In randomized, controlled trials of bisphosphonates, high pre-treatment levels of bone turnover markers (BTM) were associated with a larger increase in bone mineral density (BMD). The purpose of this study was to examine this correlation in a real-world setting.
Methods
In this registry-based cohort study of osteoporosis patients (n = 158) receiving antiresorptive therapy, the association between pre-treatment levels of plasma C-telopeptide of type I Collagen (CTX) and/or N-terminal propeptide of type I procollagen (PINP) and change in bone mineral density (BMD) at lumbar spine, total hip, and femoral neck upon treatment was examined. Patients were grouped according to their pre-treatment BTM levels, defined as values above and below the geometric mean for premenopausal women.
Results
Pre-treatment CTX correlated with annual increase in total hip BMD, where patients with CTX above the geometric mean experienced a larger annual increase in BMD (p = 0.008) than patients with CTX below the geometric mean. The numerical pre-treatment level of CTX showed a similar correlation at all three skeletal sites (total hip (p = 0.03), femoral neck (p = 0.04), and lumbar spine (p = 0.0003)). A similar association was found for PINP where pre-treatment levels of PINP above the geometric mean correlated with a larger annual increase in BMD for total hip (p = 0.02) and lumbar spine (p = 0.006).
Conclusion
Measurement of pre-treatment BTM levels predicts osteoporosis patients’ response to antiresorptive treatment. Patients with high pre-treatment levels of CTX and/or PINP benefit more from antiresorptive treatment with larger increases in BMD than patients with lower pre-treatment levels.
中文翻译:
基线骨转换标志物水平可以预测骨质疏松症患者抗吸收治疗期间骨矿物质密度的变化:哥本哈根骨转换标志物研究
概括
对于骨转换率高的患者,抗吸收性骨质疏松症治疗可能更有效。在这项包括临床数据的登记研究中,用生化标志物测量的高治疗前骨转换与较高的骨矿物质密度增加相关。骨转换标志物可能是识别从抗骨吸收治疗中获益最多的患者的有用工具。
介绍
在双膦酸盐的随机对照试验中,治疗前高水平的骨转换标志物 (BTM) 与骨矿物质密度 (BMD) 的较大增加有关。本研究的目的是在现实世界环境中检验这种相关性。
方法
在这项针对接受抗再吸收治疗的骨质疏松症患者 ( n = 158)的基于注册的队列研究中, 治疗前血浆 I 型胶原蛋白 C 端肽 (CTX) 和/或 I 型前胶原 N 端前肽水平之间的相关性。检查治疗后腰椎、全髋和股骨颈的 PINP) 和骨矿物质密度 (BMD) 变化。患者根据治疗前 BTM 水平进行分组,定义为高于和低于绝经前妇女几何平均值的值。
结果
治疗前 CTX 与总髋骨 BMD 的年度增加相关,其中 CTX 高于几何平均数的患者的 BMD 年度增加 比 CTX 低于几何平均数的患者更大( p = 0.008)。CTX 的数值预处理水平在所有三个骨骼部位(全髋(p = 0.03)、股骨颈(p = 0.04)和腰椎(p = 0.0003))显示出相似的相关性。对 PINP 也发现了类似的关联,其中高于几何平均值的 PINP 治疗前水平与全髋 ( p = 0.02) 和腰椎 ( p = 0.006) 的 BMD 每年增加较大相关。
结论
治疗前 BTM 水平的测量可预测骨质疏松症患者对抗吸收治疗的反应。与治疗前水平较低的患者相比,治疗前 CTX 和/或 PINP 水平较高的患者从抗再吸收治疗中获益更多,BMD 增加幅度更大。