| Objectives To study the clinical effects of alendronate,calcitriol and calcium on bone mineral density and hip geometry in patients with osteoporosis(OP)and osteoarthritis(OA)and to explore the effect of OA on osteoporosis therapy.Methods 144 patients diagnosed with osteoporosis at the osteoporosis clinic and inpatient department of hospital of North China University of Science and Technology were collected from May 2016 to October 2019.They were divided into osteoporosis with osteoarthritis group(OP+OA group,n=73)and osteoporosis group(OP group,n=71)according the diagnosis.Both the OP+OA group and the OP group were treated with alendronate,calcitriol,and calcium for 2 years.Before treatment,all subjects’ basic information such as age,height,weight was recorded.Before treatment,previous menstrual history,fracture history,drug history and chronic medical history were inquired.Bone mineral density of lumbar vertebrae(L1～4,sum of lumbar vertebrae)and left femoral neck were measured before and after treatment.The geometric structure indexes of the left hip of all subjects,such as femoral neck cross-sectional area(CSA),femoral neck cross-sectional moment of inertia(CSMI),femoral neck sectional modulus(Z),and femoral neck cortical thickness(CT),femoral neck buckling ratio(BR),were measured before and after treatment.Serum biochemical indexes such as calcium(Ca),phosphorus(P),25-hydroxyvitamin D(25(OH)D)were measured in before and after treatment.The adverse reactions of all subjects were recorded during treatment.The changes of bone mineral density,hip geometry and other related indexes before and after treatment in the OP+OA group and the OP group were compared,and the occurrence of adverse reactions in the two groups was observed.Results 1 Before treatment,there was no significant difference in general data,bone mineral density,hip geometry parameters,and VAS score between the OP+OA group and the OP group(P>0.05);the WOMAC score of OP+OA group was significantly higher than that of OP group and the difference was statistically significant(P<0.05).2 After 1 year of treatment,the bone mineral density,hip geometry parameters,VAS score and WOMAC score of the two groups were significantly improved compared with those before treatment and the difference was statistically significant(P<0.05);there was no significant difference in bone mineral density,hip geometry parameters,and WOMAC score between the OP+OA group and the OP group(P>0.05);the VAS score of the OP+OA group was significantly higher than that of the OP group and the difference was statistically significant(P<0.05).3 After 2 years of treatment,the bone mineral density,hip geometry parameters,VAS score and WOMAC score of the two groups were significantly improved compared with those before treatment and the difference was statistically significant(P<0.05);the bone mineral density(L1～3,lumbar spine,femoral neck),hip geometry parameters(CSA,CSMI,Z)of the OP+OA group were significantly lower than that of the OP group and the difference was statistically significant(P<0.05);There was no statistically significant difference in bone mineral density and CT between OP+OA group and OP group(P>0.05);BR、VAS score and WOMAC score of OP+OA group were significantly higher than that of OP group and the difference was statistically significant(P<0.05).4 After 2 years of treatment,the improvement of bone mineral density,hip geometry parameters(CSA,CSMI,Z,BR)and VAS score in the OP+OA group was significantly lower than that of OP group and the difference was statistically significant(P<0.05);WOMAC score improvement of OP+OA group was significantly higher than that of OP group and the difference was statistically significant(P<0.05).5 After 2 years of treatment,the growth rate of bone mineral density of lumbar vertebrae in the two groups was higher than that of femoral neck(P<0.05).6 In the course of treatment,6 patients in the OP+OA group took oral alendronate sodium and experienced symptoms such as stomach upset,muscle pain,and rash,and 2 cases of constipation symptoms after oral calcium administration;4 patients in the OP group took oral alendronate sodium and experienced symptoms,such as stomach upset,muscle pain,rash and other symptoms.All subjects can tolerate and did not withdraw from the experiment due to adverse reactions.Conclusions 1 Alendronate,calcitriol combined with calcium in the treatment of osteoporosis whether accompanied by osteoarthritis or not can improve the hip geometry and joint symptoms,increase bone mineral density,and improve lumbar spine better than femoral neck.2 Osteoarthritis has an effect on the treatment of osteoporosis,delaying the improvement of bone mineral density and hip geometry.3 Combined anti-osteoporosis medication used for osteoporosis with osteoarthritis for 1～2 years,no serious adverse reactions occurred in the patients.Figure 4;Table 10;Reference 140... |
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