地舒单抗对绝经后骨质疏松患者短期骨代谢标志物及糖脂代谢的影响

Effect of Denosumab on Short-term Bone Metabolism Markers and Glucose and Lipid Metabolism in Postmenopausal Patients with Osteoporosis

目的:探讨地舒单抗对绝经后骨质疏松患者的骨代谢标志物及糖脂代谢的影响。方法:回顾性分析2021年6月—2022年4月北京医院门诊给予地舒单抗治疗的绝经后骨质疏松症患者56例的临床资料,比较治疗前后1个月骨代谢标志物及其他代谢指标情况。结果:治疗后,Ⅰ型胶原氨基端前肽水平低于治疗前,差异有统计学意义(P=0.000);治疗前后血清Ⅰ型胶原C端肽比较,差异无统计学意义(P=0.114)。治疗前后患者甲状旁腺激素、血钙、血磷、尿钙、尿磷水平比较,差异无统计学意义(P>0.05)。治疗后,患者血肌酐水平低于治疗前,总胆固醇水平高于治疗前,差异有统计学意义(P<0.05);治疗前后血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、维生素D3、白蛋白、丙氨酸氨基转移酶、谷草转氨酶、总胆红素、直接胆红素、尿素氮水平比较,差异无统计学意义(P>0.05)。结论:绝经期骨质疏松的患者应用地舒单抗治疗,可降低骨代谢标志物水平,不会影响患者糖、脂代谢及肝肾功能,短期治疗效果明显,安全性好。

Objective:To investigate the effect of denosumab on bone metabolism markers and glucose and lipid metabolism in postmenopausal patients with osteoporosis.Methods:The clinical data of 56 postmenopausal osteoporosis patients treated with denosumab in Beijing Hospital from June 2021 to April 2022 were retrospectively analyzed.The bone metabolism markers and other metabolic indicators were compared one month before and after treatment.Results:After treatment,the amino-terminal propeptide level of typeⅠcollagen was lower than that before treatment,and the difference was statistically significant(P=0.000).There was no significant difference in serum typeⅠcollagen C-terminal peptide before and after treatment(P=0.114).There was no significant difference in the levels of parathyroid hormone,blood calcium,blood phosphorus,urine calcium,and urine phosphorus before and after treatment(P>0.05).After treatment,the serum creatinine level of the patients was lower than before treatment,and the total cholesterol level was higher than before treatment,and the difference was statistically significant(P<0.05).Comparison of blood glucose,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglyceride,vitamin D3,albumin,alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,and blood urea nitrogen before and after treatment,the difference was not statistically significant(P>0.05).Conclusion:The application of denosumab in menopausal osteoporosis patients can reduce the level of bone metabolism markers,and will not affect the glucose and lipid metabolism,liver and kidney function of the patients.The short-term treatment effect is obvious and the safety is good.