골다공증이 있는 한국 폐경 여성에서 1년의 Teriparatide 치료 후 골밀도와 골교체 표지자
Bone Mineral Density and Bone Turnover Markers after One-year Teriparatide Treatment in Korean Postmenopausal Women with Osteoporosis
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목적: 재조합 부갑상선 호르몬인 teriparatide는 골형성을 유도하고 척추 및 비척추 골절을 감소시킨다. 본 연구에서는 골다공증이 있는 한국 폐경 여성을 대상으로 1년의 teriparatide 치료 시 오는 골밀도와 골교체 표지자 변화를 평가하였다. 방법: 골다공증이 있는 폐경 여성이 등록되었고, 이들은 1년 동안 매일 자가로 teriparatide 20μg을 피하주사했다. 요추와 대퇴골 골밀도 및 골교체 표지자인 osteocalcin, C-telopeptide of collagen cross-links (CTX), alkaline phosphatase는 teriparatide 치료 전과 1년 후 측정되었다. 결과: 요추 골밀도는 teriparatide 치료 1년 후 유의하게 증가하였다(4.4%, P<0.01). 그러나 대퇴골 경부의 골밀도는 치료 시작 전보다 감소하였다(-9.7%, P<0.05). 골교체 표지자인 osteocalcin (148.5%), CTX (67.6%), alkaline phosphatase (56.7%)는 1년 후 모두 유의하게 증가하였다(P<0.001 for all). 결론: 골다공증이 있는 한국 폐경 여성에서 1년의 teriparatide 치료는 요추 골밀도와 골교체 표지자를 유의하게 증가시켰다. 앞으로 많은 사람을 대상으로 한 장기간의 체계화된 전향적 연구가 시행되어야 할 것이다.
Abstract
Objectives: Recombinant teriparatide, a bone anabolic agent, is known to result in a net positive bone balance and reduce vertebral and nonvertebral fracture incidence. The objective of this study was to evaluate the changes of bone mineral density(BMD) and bone turnover markers after one-year teriparatide treatment in Korean postmenopausal women with osteoporosis. Methods: The enrolled postmenopausal women with osteoporosis were administered teriparatide 20μg/ day injection for one year. BMD at the lumber spine and the hip were measured at baseline and after one year by dual-energy X-ray absorptiometry. Also, serum bone turnover markers, such as osteocalcin, C-telopeptide of collagen cross-links(CTX), and alkaline phosphatase were measured at baseline and after one year. Results: Lumbar spine BMD increased from baseline(4.4%, P<0.01), but femoral neck BMD decreased from baseline(-9.7%, P<0.05). Bone turnover markers, such as osteocalcin(148.5%), CTX(67.6%), and alkaline phosphatase(56.7%) increased from baseline(P<0.001 for all). Conclusion: One year of teriparatide treatment significantly increased lumbar spine BMD and bone turnover markers in Korean postmenopausal women with osteoporosis. The large-populated prospective study with longer administered period will be needed in the future.
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