Role of bisphosphonates in osteoporosis caused by adult growth hormone deficiency  

双膦酸盐在成人生长激素缺乏所致骨质疏松症中的作用

作　　者：CHENG Zhiling LI Jie CHEN Zhongpei REN Wei 程智玲;李洁;陈中沛;任伟(重庆市中医院内分泌科,重庆400011;重庆医科大学附属第一医院内分泌科,重庆400016)

机构地区：[1]Department of Endocrinology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400011 [2]Department of Endocrinology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

出　　处：《中南大学学报（医学版）》2024年第6期839-847,共9页Journal of Central South University ：Medical Science

基　　金：This work was supported by the Special Project of Performance Incentive and Guidance for Scientific Research Institutions of Chongqing,China (jxyn2022-5)。

摘　　要：In recent years,growth hormone and insulin-like growth factors have become key regulators of bone metabolism and remodeling,crucial for maintaining healthy bone mass throughout life.Studies have shown that adult growth hormone deficiency leads to alterations in bone remodeling,significantly affecting bone microarchitecture and increasing fracture risk.Although recombinant human growth hormone replacement therapy can mitigate these adverse effects,improving bone density,and reduce fracture risk,its effectiveness in treating osteoporosis,especially in adults with established growth hormone deficiency,seems limited.Bisphosphonates inhibit bone resorption by targeting farnesyl pyrophosphate synthase in osteoclasts,and clinical trials have confirmed their efficacy in improving osteoporosis.Therefore,for adult growth hormone deficiency patients with osteoporosis,the use of bisphosphonates alongside growth hormone replacement therapy is recommended.近年来,生长激素和胰岛素样生长因子已成为骨代谢和重塑的关键调节剂,对于生命各阶段健康骨量的维持均至关重要。研究表明,成人生长激素缺乏会引发骨重塑变化,显著改变骨微结构并增加骨折风险。虽然重组人生长激素替代疗法可以减轻这些负面影响,提高骨密度并降低骨折风险,但其治疗骨质疏松症的效果,特别是对于已有生长激素缺乏症的成年人,似乎有限。双膦酸盐通过抑制破骨细胞中的法尼醇焦磷酸合酶起抗骨吸收的作用,临床试验已证实其可有效改善骨质疏松。因此,对患有骨质疏松的成人生长激素缺乏症患者,建议在使用生长激素替代疗法的同时使用双膦酸盐。

关 键 词：growth hormone adult growth hormone deficiency OSTEOPOROSIS BISPHOSPHONATES insulin-like growth factor 1 SKELETON 

分 类 号：R580[医药卫生—内分泌]