胶原肽联合钙尔奇D治疗绝经后骨质疏松患者疗效分析
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摘要
目的研究胶原肽联合钙尔奇D对绝经后骨质疏松患者的疗效。方法 202例绝经后骨质疏松症患者随机分为试验组(每日口服胶原肽10 g联合钙尔奇D 600 mg)和对照组(口服钙尔奇D 600 mg),进行为期6个月的治疗。利用化学发光法检测血清总骨1型前胶原N端肽(N-propeptide of type 1 collagen,PINP)、β-I型胶原交联羧基末端肽(C-terminal crosslinked telopeptides of type 1 collagen,β-CTX)、血清骨钙素(osteocalcin,OC)、25-羟维生素D3[25 hydroxy vitamine D3,25(OH)D3]、甲状旁腺素(parathyroid hormone,PTH)。利用双能X线(dual energy X-ray absorptiometry,DXA)吸收法进行腰椎、股骨骨密度(bone mineral density,BMD)检测。结果治疗6个月后,口服胶原肽联合钙尔奇D能够更有效地缓解骨质疏松导致的骨痛。试验组患者血清PTH、25(OH)D3及OC水平明显高于治疗前(P<0.01)及对照组(P<0.01)。对照组患者治疗后血清PINP水平明显低于治疗前(P<0.01),而PTH、25(OH)D3、β-CTX水平明显高于治疗前(P<0.01)。试验组患者治疗后血清PINP水平明显高于对照组(P<0.01),而β-CTX水平低于对照组(P<0.05)。试验组患者腰椎L_2、L_4及股骨颈、粗隆间BMD明显高于治疗前(P<0.01)及对照组(P<0.05)。试验组患者各部位BMD均显著高于治疗前(P<0.01);而对照组患者治疗后上述各指标差异无统计学意义(P>0.05)。结论口服胶原肽联合钙尔奇D既能促进骨形成,又能抑制骨吸收,进一步增加BMD,并且可以缓解骨质疏松引起的疼痛。
Objective To study the effects of bone collagen peptide combined with Caltrate D on the treatment of postmenopausal osteoporosis. Methods 202 postmenopausal women with osteoporosis were randomized to receive oral administration of 10 g collagen peptide combined with 600 mg Caltrate D(experimental group) or 600 mg Caltrate D(control group) daily for 6 months. Serum total N-terminal propeptide of type I procollagen(PINP), β-isomerized C-terminal cross-linked telopeptide of type I collagen(β-CTX), N-MID Osteocalcin(OC), 25-hydroxyvitamin D3(25-OH D3) and parathyroid hormone(PTH) were detected by chemiluminescence. BMD of the lumbar spine and the femur was measured using dual-energy X-ray absorption. Results After 6 months of treatment, oral collagen peptide combined with Caltrate D was more effective in alleviating bone pain caused by osteoporosis. The levels of serum PTH, 25-OH D3 and N-MID Osteocalcin(OC) in the experimental group were significantly higher than those before treatment(P<0.01) and the control group(P<0.01). Serum PINP level of the control group after treatment was significantly lower than that before treatment(P<0.01), while the levels of PTH, 25-OH D3 and β-CTX were significantly higher than those before treatment(P<0.01). Serum PINP level in the experimental group was significantly higher than that in the control group(P<0.01), while the level of β-CTX in the experimental group was lower than that in the control group(P<0.05). BMD of L2-L4 of lumbar spine and of femoral neck and intertrochanter of femur in the experimental group was significantly higher than that before treatment(P<0.01) and the control group(P<0.05). BMD of all sites in the experimental group was significantly higher than that before treatment(P<0.01), but there was no statistical significance in the above indexes after treatment in the control group(P>0.05). Conclusion Oral collagen peptide combined with Caltrate D not only could promote bone formation, but also could inhibit bone absorption, further increase BMD and alleviate the pain caused by osteoporosis.
Objective To study the effects of bone collagen peptide combined with Caltrate D on the treatment of postmenopausal osteoporosis. Methods 202 postmenopausal women with osteoporosis were randomized to receive oral administration of 10 g collagen peptide combined with 600 mg Caltrate D(experimental group) or 600 mg Caltrate D(control group) daily for 6 months. Serum total N-terminal propeptide of type I procollagen(PINP), β-isomerized C-terminal cross-linked telopeptide of type I collagen(β-CTX), N-MID Osteocalcin(OC), 25-hydroxyvitamin D3(25-OH D3) and parathyroid hormone(PTH) were detected by chemiluminescence. BMD of the lumbar spine and the femur was measured using dual-energy X-ray absorption. Results After 6 months of treatment, oral collagen peptide combined with Caltrate D was more effective in alleviating bone pain caused by osteoporosis. The levels of serum PTH, 25-OH D3 and N-MID Osteocalcin(OC) in the experimental group were significantly higher than those before treatment(P<0.01) and the control group(P<0.01). Serum PINP level of the control group after treatment was significantly lower than that before treatment(P<0.01), while the levels of PTH, 25-OH D3 and β-CTX were significantly higher than those before treatment(P<0.01). Serum PINP level in the experimental group was significantly higher than that in the control group(P<0.01), while the level of β-CTX in the experimental group was lower than that in the control group(P<0.05). BMD of L2-L4 of lumbar spine and of femoral neck and intertrochanter of femur in the experimental group was significantly higher than that before treatment(P<0.01) and the control group(P<0.05). BMD of all sites in the experimental group was significantly higher than that before treatment(P<0.01), but there was no statistical significance in the above indexes after treatment in the control group(P>0.05). Conclusion Oral collagen peptide combined with Caltrate D not only could promote bone formation, but also could inhibit bone absorption, further increase BMD and alleviate the pain caused by osteoporosis.
引文
[1] Ao SF, Gomes PS, Cola?o BJ, et al. The biomaterial mediated healing of critical size bone defects in the ovariectomized rat[J]. Osteoporos Int, 2014, 25(5):1535-1545.
[2] 刘潞琳,王靖.口服复方钙剂结合运动处方治疗老年性骨质疏松症[J].医学临床研究,2012,29(4):743-745.
[3] Peng YL, Hu HY, Luo JC, et al. Alendronate,a bisphosphonate, increased upper and lower gastrointestinal bleeding:risk factor analysis from a nationwide population-based study[J]. Osteoporosis Int, 2014, 25(5):1617-1623.
[4] Liu JL,Zhang B,Song SJ,et al.Bovine collagen peptides compounds promote the proliferation and differentiation of MC3T3-E1 pre-osteoblasts[J].PLoS One, 2014,9(6):e99920.
[5] Kim HK, Kim MG, Leem KH. Osteogenic activity of collagen peptide via ERK/MAPK pathway mediated boosting of collagen synthesis and its therapeutic efficacy in osteoporotic bone byback-scattered electron imaging and microarchitecture analysis[J]. Molecules, 2013, 18(10):15474-15489.
[6] Guillerminet F, Beaupied H, Fabien S, et al. Hydrolyzed collagen improves bone metabolism and biomechanical parameters in ovariectomized mice: An in vitro and in vivo study[J]. Bone, 2010,46(10):827-834.
[7] 黎宗保.激素替代疗法联合阿仑膦酸钠治疗对绝经后骨质疏松症患者子宫内膜及骨代谢的影响[J].山东医药,2016,56(25):90-92.
[8] 张俐,许秀萍,张嘉利,等.阿仑膦酸钠对2型糖尿病合并骨质疏松患者骨代谢标志物的影响[J].中国骨质疏松杂志,2013,19(6):576-579.
[9] Gesle K, Poschl E, Aigner T. Collagens-structure, function, and biosynthesis[J]. Adv Drug Delivery Rev, 2003, 55(12): 1531-1546.
[10] Leeming DJ, Heneriksen K, Byrjalsen I, et al. Is bone quality associated with collagen age?[J]. Osteoporos Int, 2009, 20(9): 1461-1470.
[11] NIH. Consensus conference: optimal calcium intake[J]. JAMA, 1994, 272: 1942-1948.
[12] Liu JL, Wang YH, Song SHJ, et al. Combination of oral administration bovine collagen peptides with calcium citrate on inhibitory effect of bone loss in ovariectomized rats[J]. PLoS One, 2015, 10(5): e0135019.
[13] 秦晋泽, 荣晓旭, 朱国兴,等. 广场舞对绝经期后骨质疏松患者的骨密度和骨转换指标影响的研究[J].中国骨质疏松杂志,2017,23(1): 43-46.
[14] Yoshimura N,Muraki S,Oka H,et al. Biochemical markers of bone turnover as predictors of osteoporosis and osteoporotic fractures in men and women: 10-year follow-up of the Taiji cohort[J]. Mod Rheumatol, 2011, 21(6): 608-620.
[15] Cupp ME, Nayak SK, Adem AS, et al. Parathyroid hormone (PTH) and PTH-related peptide domains contributing to activation of different PTH receptor-mediated signaling pathways[J]. J Pharmacol Exp Ther,2013, 345(3):404-418.
[16] 金勇,范虹. 2型糖尿病合并骨质疏松患者维生素D水平及其危险因素[J]. 中国老年学杂志, 2016, 36(8): 3722-3724.
[17] 刘厚福,赵钊,胡藩,等.骨胶原肽对老年人骨密度和骨代谢指标的影响[J]. 营养学报, 2016, 38(2):124-127.
[18] Li M, Zhang ZL, Liao EY, et al. Effect of low-dose alendronate treatment on bone mineral density and bone turn over markers in Chinese postmenopausal women with osteopenia and osteoporosis[J]. Menopause, 2013,20(1):72-78.
[2] 刘潞琳,王靖.口服复方钙剂结合运动处方治疗老年性骨质疏松症[J].医学临床研究,2012,29(4):743-745.
[3] Peng YL, Hu HY, Luo JC, et al. Alendronate,a bisphosphonate, increased upper and lower gastrointestinal bleeding:risk factor analysis from a nationwide population-based study[J]. Osteoporosis Int, 2014, 25(5):1617-1623.
[4] Liu JL,Zhang B,Song SJ,et al.Bovine collagen peptides compounds promote the proliferation and differentiation of MC3T3-E1 pre-osteoblasts[J].PLoS One, 2014,9(6):e99920.
[5] Kim HK, Kim MG, Leem KH. Osteogenic activity of collagen peptide via ERK/MAPK pathway mediated boosting of collagen synthesis and its therapeutic efficacy in osteoporotic bone byback-scattered electron imaging and microarchitecture analysis[J]. Molecules, 2013, 18(10):15474-15489.
[6] Guillerminet F, Beaupied H, Fabien S, et al. Hydrolyzed collagen improves bone metabolism and biomechanical parameters in ovariectomized mice: An in vitro and in vivo study[J]. Bone, 2010,46(10):827-834.
[7] 黎宗保.激素替代疗法联合阿仑膦酸钠治疗对绝经后骨质疏松症患者子宫内膜及骨代谢的影响[J].山东医药,2016,56(25):90-92.
[8] 张俐,许秀萍,张嘉利,等.阿仑膦酸钠对2型糖尿病合并骨质疏松患者骨代谢标志物的影响[J].中国骨质疏松杂志,2013,19(6):576-579.
[9] Gesle K, Poschl E, Aigner T. Collagens-structure, function, and biosynthesis[J]. Adv Drug Delivery Rev, 2003, 55(12): 1531-1546.
[10] Leeming DJ, Heneriksen K, Byrjalsen I, et al. Is bone quality associated with collagen age?[J]. Osteoporos Int, 2009, 20(9): 1461-1470.
[11] NIH. Consensus conference: optimal calcium intake[J]. JAMA, 1994, 272: 1942-1948.
[12] Liu JL, Wang YH, Song SHJ, et al. Combination of oral administration bovine collagen peptides with calcium citrate on inhibitory effect of bone loss in ovariectomized rats[J]. PLoS One, 2015, 10(5): e0135019.
[13] 秦晋泽, 荣晓旭, 朱国兴,等. 广场舞对绝经期后骨质疏松患者的骨密度和骨转换指标影响的研究[J].中国骨质疏松杂志,2017,23(1): 43-46.
[14] Yoshimura N,Muraki S,Oka H,et al. Biochemical markers of bone turnover as predictors of osteoporosis and osteoporotic fractures in men and women: 10-year follow-up of the Taiji cohort[J]. Mod Rheumatol, 2011, 21(6): 608-620.
[15] Cupp ME, Nayak SK, Adem AS, et al. Parathyroid hormone (PTH) and PTH-related peptide domains contributing to activation of different PTH receptor-mediated signaling pathways[J]. J Pharmacol Exp Ther,2013, 345(3):404-418.
[16] 金勇,范虹. 2型糖尿病合并骨质疏松患者维生素D水平及其危险因素[J]. 中国老年学杂志, 2016, 36(8): 3722-3724.
[17] 刘厚福,赵钊,胡藩,等.骨胶原肽对老年人骨密度和骨代谢指标的影响[J]. 营养学报, 2016, 38(2):124-127.
[18] Li M, Zhang ZL, Liao EY, et al. Effect of low-dose alendronate treatment on bone mineral density and bone turn over markers in Chinese postmenopausal women with osteopenia and osteoporosis[J]. Menopause, 2013,20(1):72-78.
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