Correlation Between Vitamin D And Adverse Reactions Induced By Diphosphate(Zoledronic Acid) In The Treatment Of Osteoporosis

Objective: To explore the possibility of various adverse reactions caused by zoledronic acid injection of bisphosphonate in the treatment of osteoporosis and to analyze the correlation between vitamin D and adverse reactions.Methods: Choice in September 2016 to December 2018,the osteoporosis in XXX hospital outpatient rheumatology clinic,endocrinology clinic of osteoporosis patients,the questionnaire survey based on the questionnaire survey project screening,829 cases of research object,and connecting with the first use of azole diphosphate injection to phosphonic acid treatment of osteoporosis in patients with adverse reactions can be divided into fever group,catarrh symptoms,muscle pain,bone pain intensified group and other adverse reactions,adverse reactions research object has a total of 741 cases,accounting for 89.4% of the total research object.According to the occurrence of different adverse reactions,it was divided into: fever group,287 cases,accounting for 34.6% of the subjects;In the carta symptom group,there were 63 cases,accounting for 7.6% of the subjects.Muscle soreness group,341 cases,accounting for 41.1% of the subjects;In the bone pain exacerbation group,there were 26 cases,accounting for 3.1% of the subjects.Other adverse reactions(mandibular osteonecrosis,liver and kidney damage,heart failure)included 24 cases,accounting for 2.9%of the subjects.The serum vitamin D levels of the subjects were tested at the time of inclusion in the study,and the serum vitamin D levels of the patients with adverse reactions were analyzed by Logistic regression.Results: In the treatment of osteoporosis,there are many adverse reactions,such as fever,catarrh,muscle pain,bone pain,mandibular osteonecrosis,liver function damage,kidney function damage and heart failure.The serum vitamin D level of patients with fever was(9.013.44)ng/ml,significantly lower than that of patients without fever(13.87 5.23)ng/ml.The serum vitamin D level of patients with exacerbation of bone pain was(8.66 4.01)ng/ml,significantly lower than that of patients without exacerbation of bone pain(13.95 5.81)ng/ml.Among them,fever,catarrhal symptoms,muscle pain and bone pain were correlated with serological vitamin D,and the difference was statistically significant(p<0.05).The difference was significant(p<0.01),especially in the fever,muscle pain and bone pain group.Conclusion: 1.In the treatment of osteoporosis patients with zoledronic acid injection,fever,catarrh symptoms,muscle pain,increased bone pain,mandibular osteonecrosis,liver function damage,kidney function damage and other adverse reactions may occur.2.When the zoledronic acid injection in the treatment of osteoporosis,there was a negative correlation between vitamin D with fever,catarrh symptoms,muscle pain and bone pain.3.Vitamin D deficiency or deficiency may be an important risk factor for fever,catarrh symptoms,muscle pain and increased bone pain in the treatment of osteoporosis with zoledronic acid.