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首页> 外文期刊>Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research >Assessment of bone microarchitecture in postmenopausal women on long-term bisphosphonate therapy with atypical fractures of the femur
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Assessment of bone microarchitecture in postmenopausal women on long-term bisphosphonate therapy with atypical fractures of the femur

机译：长期双膦酸盐治疗股骨非典型性骨折对绝经后妇女骨微结构的评估

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Reports of atypical femoral fractures (AFFs) in patients receiving long- term bisphosphonate therapy have raised concerns regarding the genesis of this rare event. Using high-resolution peripheral quantitative computed tomography (HR-pQCT), we conducted a study to evaluate bone microarchitecture in patients who had suffered an AFF during long-term bisphosphonate treatment. The aim of our study was to evaluate if bone microarchitecture assessment could help explain the pathophysiology of these fractures. We compared bone volumetric density and microarchitectural parameters measured by HR-pQCT in the radius and tibia in 20 patients with AFFs with 35 postmenopausal women who had also received long-term bisphosphonate treatment but had not experienced AFFs, and with 54 treatment-naive postmenopausal women. Control groups were similar in age, body mass index (BMI), and bone mineral density (BMD). Mean age of the 20 patients with AFFs was 71 years, mean lumbar spine T-score was -2.2, and mean femoral neck T-score was -2. Mean time on bisphosphonate treatment was 10.9 years (range, 5-20 years). None of the patients had other conditions associated with AFFs such as rheumatoid arthritis, diabetes or glucocorticoid use. There were no statistically significant differences in any of the parameters measured by HR-pQCT between postmenopausal women with or without treatment history and with or without history of atypical fractures. We could not find any distinctive microarchitecture features in the peripheral skeleton of women who had suffered an atypical fracture of the femur while receiving bisphosphonate treatment. This suggests that risk of developing an atypical fracture is not related to bone microarchitecture deterioration. Our results indicate that there may be other individual factors predisposing to atypical fractures in patients treated with bisphosphonates, and that those are independent of bone microarchitecture. In the future, identification of those factors could help prevent and understand the complex physiopathology of these rare events.
机译：长期接受双膦酸盐治疗的患者的非典型股骨骨折（AFF）的报告引起了人们对该罕见事件发生的担忧。我们使用高分辨率外围定量计算机断层扫描（HR-pQCT），进行了一项研究，以评估长期双膦酸盐治疗期间患有AFF的患者的骨微结构。我们研究的目的是评估骨骼微结构评估是否可以帮助解释这些骨折的病理生理。我们比较了由HR-pQCT测量的with骨和胫骨的骨体积密度和微体系结构参数，对20例AFF患者，35例绝经后妇女也接受了长期双膦酸盐治疗但未经历AFF的患者以及54例初次绝经后妇女进行了比较。 。对照组的年龄，体重指数（BMI）和骨矿物质密度（BMD）相似。 20名AFF患者的平均年龄为71岁，腰椎T分数为-2.2，股骨颈T分数为-2。双膦酸盐治疗的平均时间为10.9年（范围5-20年）。所有患者均无其他与AFF相关的疾病，例如类风湿关节炎，糖尿病或糖皮质激素的使用。在有或没有治疗史以及有或没有非典型骨折史的绝经后妇女中，HR-pQCT测量的任何参数均无统计学上的显着差异。在接受双膦酸盐治疗的股骨非典型性骨折妇女的外周骨骼中，我们找不到任何明显的微结构特征。这表明发生非典型骨折的风险与骨微结构的恶化无关。我们的结果表明，在使用双膦酸盐治疗的患者中，可能还有其他一些易诱发非典型骨折的因素，并且这些因素与骨微结构无关。将来，识别这些因素可能有助于预防和了解这些罕见事件的复杂生理病理。

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