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- Titel:
A longitudinal HR-pQCT study of alendronate treatment in postmenopausal women with low bone density: Relations among density, cortical and trabecular microarchitecture, biomechanics, and bone turnover.
- Dokumenttyp:
- journal article
- Autor(en):
- Burghardt, AJ; Kazakia, GJ; Sode, M; de Papp, AE; Link, TM; Majumdar, S
- Abstract:
- The goal of this study was to characterize longitudinal changes in bone microarchitecture and function in women treated with an established antifracture therapeutic. In this double-blind, placebo-controlled pilot study, 53 early postmenopausal women with low bone density (age = 56 ± 4 years; femoral neck T-score = -1.5 ± 0.6) were monitored by high-resolution peripheral quantitative computed tomography (HR-pQCT) for 24 months following randomization to alendronate (ALN) or placebo (PBO) treatment groups. Subjects underwent annual HR-pQCT imaging of the distal radius and tibia, dual-energy X-ray absorptiometry (DXA), and determination of biochemical markers of bone turnover (BSAP and uNTx). In addition to bone density and microarchitecture assessment, regional analysis, cortical porosity quantification, and micro-finite-element analysis were performed. After 24 months of treatment, at the distal tibia but not the radius, HR-pQCT measures showed significant improvements over baseline in the ALN group, particularly densitometric measures in the cortical and trabecular compartments and endocortical geometry (cortical thickness and area, medullary area) (p< .05). Cortical volumetric bone mineral density (vBMD) in the tibia alone showed a significant difference between treatment groups after 24 months (p< .05); however, regionally, significant differences in Tb.vBMD, Tb.N, and Ct.Th were found for the lateral quadrant of the radius (p< .05). Spearman correlation analysis revealed that the biomechanical response to ALN in the radius and tibia was specifically associated with changes in trabecular microarchitecture (|?| = 0.51 to 0.80, p< .05), whereas PBO progression of bone loss was associated with a broad range of changes in density, geometry, and microarchitecture (|?| = 0.56 to 0.89, p< .05). Baseline cortical geometry and porosity measures best predicted ALN-induced change in biomechanics at both sites (?> 0.48, p< .05). These findings suggest a more pronounced response to ALN in the tibia than in the radius, driven by trabecular and endocortical changes.
- Zeitschriftentitel:
- J Bone Miner Res
- Jahr:
- 2010
- Band / Volume:
- 25
- Heft / Issue:
- 12
- Seitenangaben Beitrag:
- 2558-71
- Sprache:
- eng
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/20564242
- Print-ISSN:
- 0884-0431
- TUM Einrichtung:
- Röntgendiagnostik
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