RESUMEN
The aim of the study was to establish the efficacy of 1-year alendronate treatment in 10 wheelchair-bound participants. In the study were included participants with z-score lower than -2.0 in one of three skeletal sites. Bone status was assessed using dual-energy X-ray absorptiometry at calcaneus and forearm and using quantitative ultrasound at hand phalanges at baseline and after a year. Laboratory variables included serum carboxyterminal telopeptide of type I collagen (ICTP) and bone alkaline phosphatase. Mean values of bone measurements did not differ between baseline and follow-up, the mean value of ICTP nonsignificantly increased and bone alkaline phosphatase significantly dropped (P<0.01). No patient treated revealed the increase in three bone densitometric variables and only one showed a decrease in ICTP exceeding 40% of baseline value. Concluding, in wheelchair-bound participants short-term alendronate therapy does not reduce bone resorption and does not improve the skeletal status.
Asunto(s)
Alendronato/uso terapéutico , Conservadores de la Densidad Ósea/uso terapéutico , Densidad Ósea/efectos de los fármacos , Resorción Ósea/tratamiento farmacológico , Personas con Discapacidad , Inmovilización , Absorciometría de Fotón , Adulto , Fosfatasa Alcalina/sangre , Resorción Ósea/sangre , Resorción Ósea/etiología , Huesos/diagnóstico por imagen , Huesos/efectos de los fármacos , Huesos/metabolismo , Colágeno Tipo I/sangre , Femenino , Humanos , Masculino , Péptidos/sangre , Estudios Prospectivos , Resultado del Tratamiento , Silla de Ruedas , Adulto JovenRESUMEN
Skeletal status and laboratory investigations may be influenced by immobilization. Thirty-six wheelchair-bound subjects and 19 age-matched controls were evaluated using measurements of bone mineral density (BMD) at the calcaneus and forearm (PIXI, Madison, WI), amplitude-dependent speed of sound at the hand phalanges (quantitative ultrasound-DBM Sonic 1200, IGEA, Modena, Italy), carboxyterminal telopeptide of type I collagen and bone alkaline phosphatase. In the whole group and in the males, bone mineral density values were significantly lower in comparison with controls (calcaneus, forearm) and in females only for calcaneus. The duration of the disease significantly influenced the calcaneal bone mineral density data. Bone alkaline phosphatase was significantly lower in the patients than in the controls. Bone resorption had a negative influence on forearm BMD. Generally, skeletal and laboratory results were not affected by duration of the disease or reason for immobilization. In conclusion, in wheelchair-bound subjects, the skeletal status was affected and bone formation was depressed.
