摘要
目的 探讨特立帕肽(teriparatide)治疗绝经后骨质疏松患者血尿酸水平的变化趋势及其与血钙的相关性,为优化特立帕肽治疗安全性管理提供帮助。方法 回顾性分析127例特立帕肽治疗患者在基线、治疗2个月、4个月、6个月时的血尿酸、血钙、甲状旁腺激素、Ⅰ型前胶原氨基端前肽(PINP)及肌酐水平。采用广义估计方程(GEE)分析指标变化趋势及血尿酸与血钙的相关性(校正时间、年龄、体质量指数)。结果 血尿酸呈升高趋势,基于GEE模型的边际均值较基线差值显著升高(2个月升高53.19μmol/L,4个月升高62.21μmol/L,6个月升高88.70μmol/L,均校正P<0.001),且6个月高于2个月(升高35.50μmol/L,校正P=0.034);血钙边际均值升高0.11 mmol/L(校正P<0.001);PINP持续上升、甲状旁腺激素下降(均P<0.001);肌酐无变化(P=0.092);血尿酸与血钙水平呈正相关(β=0.405,P<0.001),血钙每升高1 mmol/L,血尿酸几何均数增加50.0%[Exp(β)=1.500,95%CI:1.307~1.719]。结论 绝经后骨质疏松患者接受特立帕肽治疗后,血尿酸呈逐渐升高趋势且与血钙上升呈正相关(β=0.405)。特立帕肽治疗过程中不仅要关注血钙的变化,同时要重视血尿酸的定期监测。
Objective To investigate the changing trend of serum uric acid levels and its correlation with serum calcium in postmenopausal osteoporotic patients treated with teriparatide,so as to provide assistance for optimizing the safety management of teriparatide therapy.Methods A retrospective analysis was performed on 127 patients treated with teriparatide,including the levels of serum uric acid,serum calcium,parathyroid hormone,procollagen typeⅠN-terminal propeptide(PINP)and creatinine at baseline,2,4,and 6 months after treatment.Generalized Estimating Equations(GEE)were used to analyze the changing trends of the indicators and the correlation between serum uric acid and serum calcium(adjusted for time,age,and BMI).Results Serum uric acid showed an increasing trend.Based on the GEE model,the marginal mean values were significantly higher than the baseline(with anincrease of 53.19μmol/L at 2 months,62.21μmol/L at 4 months,and 88.70μmol/L at 6 months,all adjusted P<0.001).Additionally,the level at 6 months was higher than that at 2 months(increased by 35.50μmol/L,adjusted P=0.034).The marginal mean of serum calcium increased by 0.11 mmol/L(adjusted P<0.001).PINP continued to rise andparathyroid hormone decreased(both P<0.001).There was no change in creatinine(P=0.092).Serum uric acid was positively correlated with serum calcium level(β=0.405,P<0.001).For each 1 mmol/L increase in serum calcium,the geometric mean of serum uric acid increased by 50.0%[Exp(β)=1.500,95%CI:1.307-1.719].Conclusion After treatment with teriparatide in postmenopausal osteoporotic patients,serum uric acid shows a gradually increasing trend and is positively correlated with the increase in serum calcium(β=0.405).During teriparatide treatment,attention should not only be paid to changes in serum calcium but also to regular monitoring of serum uric acid.
作者
张龙春
朱秀芬
林华
ZHANG Longchun;ZHU Xiufen;LIN Hua(Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing 210008,China)
出处
《中国骨质疏松杂志》
北大核心
2025年第12期1753-1758,共6页
Chinese Journal of Osteoporosis
关键词
特立帕肽
骨质疏松
血尿酸
血钙
teriparatide
osteoporosis
serum uric acid
serum calcium
