| Objective : To investigate the clinical characteristics of bone metabolism in elderly women patients with osteoporosis(over 80 years old)and the effect of taking bisphosphonate;and to explore the best time to assess the changes of bone mineral density and bone turnover markers after drug withdrawal.Methods:This study consists of two parts.The first part: Back from 2005 August to 2013 August in Shanghai First People's hospital out-patient,treatment of bisphosphonate drugs more than 12 months,there were 232 elderly women patients with osteoporosis at the age of over 80(the aged group)and 454 non old postmenopausal women patients with osteoporosis at the age of 47-65(the control group)which have been measured the bone mineral density and bone metabolism before and after treatment.Record these persons' clinical datas before and after treatment.Excel 2007 and the SPSS software were used to sort the data,classify and statistical analyse.The second part: Back from 2008 August to 2011 October in Shanghai First People's hospital osteoporosis out-patient(T?-2.5),treatment of bisphosphonate drugs more than or equal to 3 years.Group A: assessment of patients after discontinuation drugs for 6 months(n = 62 cases);Group B: assessment of patients after withdrawal drugs for 6 months(55 cases);Group C: assessment the patients after withdrawal drugs for 6 months and 12 months(n=17 cases).Record these persons' clinical datas before and after treatment.Excel 2007 and the SPSS softwares were used to sort the data,classify and statistical analyse.Results: The first part: 1?There was no significant difference in BMI,serum calcium,phosphorus and lumbar spine BMD between two groups before treatment.The level of 25-OHD,BTM,femoral neck BMD and hip joint BMD in the aged group were significantly lower than that in the control group before treatment(P<0.05).2?Bone turnover markers were decreased,BMD and 25-OHD were increased after bisphosphonate treatment for 12 months.The percent changes in the lumbar spine,femoral neck and hip joint in aged group is lower than that in the control group after bisphosphonate treatment for 12 months,but the difference between the two groups was not statistically significant(P>0.05).The percent changes of bone turnover markers in aged group were lower than these in the control group after bisphosphonate treatment for 12 months,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in the percent changes in the serum calcium and phosphorus after bisphosphonate treatment for 12 months.The second part:1.Group A: Compared to the baseline bone mineral density,the lumbar vertebrae,femoral neck and total hip bone mineral density of the end-of-treatment were decreased,which lumbar spine and hip bone mineral density changes have significant difference(P < 0.05);2.Group B: Compared to the baseline bone mineral density,the lumbar vertebrae,femoral neck and total hip bone mineral density of the end-of-treatment were decreased more significantly,which lumbar spine and hip bone mineral density changes have significant difference(P < 0.05);femoral neck BMD was significantly lower(P=0.085);3.Group C: Assessment the patients after withdrawal drugs for 6 months lumbar spine,femoral neck and hip bone mineral density have decreased,assessment the patients after withdrawal drugs for 12 months these indicators were further reduced.4.Compared with baseline bone turnover index point,bone turnover markers(BTM)of groups were increased significantly,and the differences were statistically significant(P < 0.05).Conclusion:1.The elderly patients with osteoporosis(over 80 years old)were in a low bone turnover state.2.Bisphosphonate can be applied to the elderly patients(? 80)with osteoporosis.3.Assessment of bone mineral density and bone turnover after discontinuation for six months is advantageous to early prediction and assessment of the outcome. |
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