Prevalence of low bone formation in untreated patients with osteoporosis.

Autor: Malluche HH; Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America., Davenport DL; Division of Healthcare Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, Kentucky, United States of America., Lima F; Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America., Monier-Faugere MC; Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Jul 19; Vol. 17 (7), pp. e0271555. Date of Electronic Publication: 2022 Jul 19 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0271555
Abstrakt: Background: Osteoporosis treatment usually starts with an antiresorber and switches to an anabolic agent if it fails. It is known that suppressing bone resorption also results in reduced bone formation. In addition, patients with prior treatment with antiresorbers may have reduced response to subsequent anabolic treatment. This study determined the prevalence of low bone formation in untreated osteoporosis patients to identify patients who may not be optimally treated under the current paradigm.
Methods: This is a cross-sectional study of bone samples stored in the Kentucky Bone Registry. Included samples were from adult patients presenting for workup of osteoporosis. Exclusion criteria were other diseases or treatments affecting bone. Patients underwent iliac crest bone biopsies after tetracycline labeling for identification of bone formation.
Results: 107 patients met study criteria, 92 White and 5 Black women and 10 White men. Forty percent of patients (43/107) had low bone formation/bone surface (BFR/BS < 0.56 mm3/cm2/yr). Clinical and serum parameters did not differ between formation groups, except for type II diabetes, which was found exclusively in the low formation group.
Conclusions: Starting treatment of osteoporotic patients with an antiresorber in all patients appears not optimal for a significant portion.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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