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Changes in bone mineral density and bone turnover markers during treatment with teriparatide in pregnancy‐ and lactation‐associated osteoporosis
Author(s) -
Hong Namki,
Kim Jo Eun,
Lee Su Jin,
Kim Se Hwa,
Rhee Yumie
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13557
Subject(s) - teriparatide , medicine , osteoporosis , bone remodeling , bone mineral , endocrinology , context (archaeology) , pregnancy , paleontology , genetics , biology
Summary Context Teriparatide ( TPTD ) therapy has been proposed as a potential treatment strategy in severe cases of pregnancy‐ and lactation‐associated osteoporosis ( PLO ) characterized by the occurrence of fragility fractures in the third trimester or early postpartum. Objective To investigate the changes in bone mineral density ( BMD ) and bone turnover markers in patients with PLO with and without TPTD treatment. Design Retrospective cohort study. Patients Thirty‐two patients with PLO who presented with multiple vertebral fractures to a tertiary institution between 2007 and 2015 were included. Measurements Changes in BMD at the lumbar spine ( LSBMD ) and proximal femur after 12 months of daily subcutaneous injections of 20 μg TPTD (n = 27) were assessed. Subjects who rejected the TPTD treatment were used as controls (n = 5). Results LSBMD increased in both subjects treated with TPTD and controls, with greater increases in the TPTD group (15.5 ± 6.6% vs 7.5 ± 7.1%, P = .020) after adjustment for age and baseline LSBMD . During follow‐up, serum levels of osteocalcin ( OCN ) and C‐telopeptide of type I collagen ( CTX ) increased significantly in the TPTD group. In multivariate linear regression models, TPTD treatment (adjusted β = 7.92, P = .032) and younger age (adjusted β = 1.06, P = .046), but not baseline LSBMD , body mass index, serum OCN level and CTX level, were independently associated with greater increases in LSBMD . Conclusions In patients with PLO , LSBMD at 12 months increased in both the TPTD ‐treated and control groups. TPTD treatment and younger age were associated with greater increases in LSMBD irrespective of baseline LSBMD .