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首页> 美国卫生研究院文献>Environmental Health Perspectives >Skeletal lead release during bone resorption: effect of bisphosphonate treatment in a pilot study.
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Skeletal lead release during bone resorption: effect of bisphosphonate treatment in a pilot study.

机译：骨吸收过程中骨骼中铅的释放：在一项初步研究中双膦酸盐治疗的效果。

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There has been renewed interest in impacts on physiologic systems in the middle and older age groups, especially from fractures and hypertension. Increased blood lead (BPb) levels in postmenopausal females, which are thought to arise from bone demineralization, may also relate to other health effects including hypertension. Taking advantage of natural differences in lead isotope signature between Australian sources of lead and those from other countries, a 2-year pilot study was performed in premenopausal and postmenopausal females and male partners in which the subjects were administered a bisphosphonate, alendronate, for 6 months. The aim of the study was to determine how lead isotopes and lead concentrations changed in relation to bone remodeling processes. Premenopausal subjects were a woman (and male partner) from Bosnia and two women from Colombia. The postmenopausal subject was a woman from Russia. Her male partner and one man from Sri Lanka were included. Multigenerational Australian subjects were 2 perimenopausal women and 1 postmenopausal woman. Each subject had blood and urine samples collected for markers of bone turnover and for lead isotope studies monthly for 7-9 months before, for 3 months during, and for up to 6 months after treatment with alendronate to inhibit bone resorption. Each subject thus acted as his or her own control. As predicted, there were significant decreases in the lead isotope ratio, (206)Pb/(204)Pb, for the migrant subjects during treatment compared with the pretreatment period (p < 0.01). After cessation of treatment, an increasing isotope ratio for the postmenopausal subject (and older male partner) occurred later than for premenopausal subjects, indicative of prolonged efficacy of the alendronate for the older subjects. The average BPb concentrations in migrant subjects decreased by about 20% during the treatment compared with the pretreatment period (p < 0.01). To our knowledge, these are the first BPb concentrations reported over monthly to quarterly intervals for environmentally exposed adults over an extended period. The changes in lead isotopic composition and lead concentration are consistent with a decrease in bone resorption and associated mobilization of lead during alendronate therapy. Older subjects at risk of fractures may benefit from treatment with antiresorptive therapy, such as the potent bisphosphonates, with the added bonus of lower release of lead from bones and thus less risk of the potential adverse health effects of increased BPb levels.
机译：人们对中老年人年龄段的生理系统的影响重新产生了兴趣，特别是骨折和高血压。绝经后女性的血铅（BPb）水平升高（据认为是由于骨骼脱盐引起的）也可能与包括高血压在内的其他健康影响有关。利用澳大利亚铅源与其他国家铅源之间自然的铅同位素特征差异，对绝经前和绝经后的女性和男性伴侣进行了为期2年的先导研究，向受试者服用双膦酸盐，阿仑膦酸盐6个月。该研究的目的是确定铅同位素和铅浓度如何与骨重塑过程有关。绝经前的受试者是波斯尼亚的一名妇女（和男性伴侣）和哥伦比亚的两名妇女。绝经后的对象是来自俄罗斯的女性。她的男伴侣和一名来自斯里兰卡的男人也包括在内。澳大利亚多代受试者为2名围绝经期妇女和1名绝经后妇女。每个受试者每月收集血液和尿液样本以进行骨转换的标志和铅同位素研究，每月一次，在用阿仑膦酸盐治疗以抑制骨吸收之前的7-9个月内，治疗期间的3个月内以及长达6个月的时间内。因此，每个主题都充当他或她自己的控件。如所预测的，与治疗前相比，治疗期间的流动受试者铅同位素比（206）Pb /（204）Pb显着降低（p <0.01）。停止治疗后，绝经后受试者（和年龄较大的男性伴侣）的同位素比值比绝经前受试者的同位素比率增加，这表明阿仑膦酸盐对年龄较大的受试者的疗效延长。与治疗前相比，治疗期间移民受试者的平均BPb浓度降低了约20％（p <0.01）。据我们所知，这是长期暴露于环境中的成年人每月至每季度报告的第一个BPb浓度。铅同位素组成和铅浓度的变化与阿仑膦酸盐治疗期间骨吸收的减少和铅的相关动员相一致。处于骨折风险中的老年受试者可能会受益于抗吸收疗法（例如强效双膦酸盐）的治疗，并增加了从骨骼中释放铅的能力，从而降低了BPb水平升高对潜在健康不利影响的风险。

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