地舒单抗联合特立帕肽治疗围绝经期女性骨质疏松症的疗效及对糖脂代谢的影响

Efficacy of Denosumab Combined with Teriparatide for Osteoporosis in Perimenopausal Women and Its Effect on Glucose and Lipid Metabolism

摘要

目的 探讨地舒单抗联合特立帕肽治疗围绝经期女性骨质疏松症（osteoporosis，OP）的疗效及对糖脂代谢的影响。方法 选取 2023 年 1 月至 2024 年 7 月厦门弘爱医院收治的 150 例围绝经期女性 OP 患者，采用随机数字表法分为对照组和观察组，每组 75 例。对照组给予特立帕肽治疗，观察组在对照组基础上联合地舒单抗注射液治疗，2 组疗程均为 12 个月。比较 2 组骨密度（bone mineral density，BMD）、骨代谢指标、颈动脉内中膜厚度（carotid intima-media thickness，CIMT）、糖脂代谢、炎症因子水平、不良反应及骨折发生率。结果 治疗后 6 个月和 12 个月，观察组全髋、股骨颈和腰椎 L₁ ~ L₄的 BMD 高于对照组，血清Ⅰ型胶原羧基端肽 β 特殊序列、总Ⅰ型原胶原 N-端前肽和骨碱性磷酸酶水平、CIMT、糖化血红蛋白 A1c、甘油三酯、总胆固醇、肿瘤坏死因子-α 和白细胞介素-6 水平低于对照组（P< 0.05）。2 组不良反应发生率相比，差异无统计学意义（P> 0.05）。观察组骨折发生率低于对照组（P< 0.05）。结论 地舒单抗联合特立帕肽能有效改善围绝经期女性 OP 患者的 BMD，协同调节骨代谢及糖脂代谢水平，降低炎症因子水平，且安全性良好。

Abstract

Objective To investigate the efficacy of denosumab combined with teriparatide in the treatment of perimenopausal women with osteoporosis (OP) and its effect on glucose and lipid metabolism. Methods A total of 150 perimenopausal women with OP admitted to Xiamen Humanity Hospital from January 2023 to July 2024 were enrolled and divided into the control group and the intervention group by the random number table method, with 75 cases in each group. The control group was treated with teriparatide, and the intervention group was additionally treated with denosumab injection on the basis of the control regimen. The treatment course of both groups was 12 months. Bone mineral density (BMD), bone metabolism markers, carotid intima-media thickness (CIMT), glucose and lipid metabolism, levels of inflammatory factors, adverse reactions and fracture incidence were compared between the two groups.Results After 6 and 12 months of treatment, the BMD of the total hip, femoral neck and L1–L4 vertebrae in the intervention group was higher than that in the control group. The levels of serum β-isomerized C-terminal telopeptide of type Ⅰ collagen, total procollagen type Ⅰ N-propeptide, bone alkaline phosphatase, CIMT, glycated hemoglobin A1c, triglyceride, total cholesterol, tumor necrosis factor-α and interleukin-6 were lower than those in the control group (all P< 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P> 0.05). The incidence of fractures in the intervention group was lower than that in the control group (P < 0.05). Conclusion Denosumab combined with teriparatide can effectively improve BMD in perimenopausal women with OP, synergistically regulate bone as well as glucose and lipid metabolism, reduce the levels of inflammatory factors, and has a favorable safety profile.

关键词

地舒单抗 / 特立帕肽 / 围绝经期 / 骨质疏松症 / 骨代谢 / 糖脂代谢

Key words

denosumab / teriparatide / perimenopausal period / osteoporosis / bone metabolism / glucose and lipid metabolism

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基金资助

厦门市自然科学基金资助项目(3502Z20227397)