Effects Of Recombinant Human Parathyroid Hormone (1-34) And Elcatonin On Bone Mineral Density And Bone Metabolism Of Postmenopausal Women With Osteoporosis

Objective: To investigate the effect of rhPTH (1-34) and elcatonin on bone mineral density (BMD) and bone metabolism in postmenopausal women with osteoporosis.Methods: Sixty-eighty postmenopausal women with osteoporosis were randomly divided into 2 groups: patients treated with rhPTH (1-34) 200U/d by subcutaneous injection (PTH group, n=46) and those treated with elcatonin 20IU/week by intramuscular injection (CT group, n=22). All patients received basic therapy with oral calcium (Ca 600mg+Vit D3 125U, qd) and the treatments lasted for 12 months. The BMD of lumbar spine (L2-4), the left femoral neck, greater trochanter and Wards triangle, serum calcium and serum phosphate were measured before and after treatment. Levels of serum bone specific alkaline phosphatase (BSAP), Type I collagen cross-linked C-telopeptide (CTX-I), serum SPARC (Secreted Protein,Acidic and Rich in Cysteine) were determined by an ELISA assay. Adverse reactions were also observed.Results: rhPTH(1-34) treatment significantly increased the lumbar spine L2-4 BMD by 7.1% (0.711±0.087vs.0.761±0.094 g / cm2, p<0.05), serum calcium by 4.6%,BSAP by 88.3% and SPARC by21.7% (2.35±0.07 vs. 2.46±0.13 mmol/L, 25.95±13.01 vs. 48.87±29.24μg/L, 174.14±13.37 vs. 205.32±63.18μg/L, all p <0.05), while decreased serum CTX-I (0.228±0.199 vs. 0.157±0.124μg/L, p <0.05). Elcatomin therapy increased the lumbar spine L2-4 BMD by 3.2% (0.732±0.093vs. 0.755±0.096 g/cm2, p <0.05), however, Elcatomin therapy did not influence serum calcium, BSAP, CTX-I and SPARC. The lumbar spine L2-4 BMD, serum calcium and serum BSAP in PTH group increased more significantly than those in CT group.Conclusion: rhPTH (1-34) could effectively promote the bone anabolism, indicating by significantly elevated BMD of bone than elcatomin did. SPARC may play an important role in promoting osteogenesis by rhPTH。...