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Objective To investigate the clinical efficacy of zoledronic acid injection (Aclasta) in the treatment of osteoporosis of different causes in women, and its influence on the indicators of bone metabolism. Methods 119 female osteoporosis patients attended to the Department of Rheumatology in our hospital from April 2012 to July 2016 were retrospectively analyzed and divided into two groups. There were 66 cases of primary osteoporosis, including 22 cases with previous fracture, in group A. They aged from 52 to 87 years, with an average age of 69. 8 ± 9. 6 years. There were 53 cases of secondary osteoporosis, including 19 cases with previous fracture, in group B. The average age of the primary osteoporosis group was significantly higher than that of the secondary osteoporosis group (P ＜ 0.05). There were no significant differences in the percentage of participants with previous fracture, levels of serum Ca, P, BUN, Cr and indicators of bone metabolism and bone mineral density (BMD) between the primary osteoporosis group and secondary osteoporosis group. Patients in both groups were treated with intravenous injection of 5 mg zoledronic acid once a year, combined with l, 25-dihydroxyvitamin D of 0. 25 μg and calcium of 600 mg with VitD l25IU daily. The treatment course was 12 months in both groups. BMD at the lumbar spine and left hip, indicators of bone metabolism, adverse events and incidences of refracture were measured at baseline and one year after the treatment, and comparisons were made between the two groups. Results After one-year treatment, BMD and serum 25(OH) D level increased significantly, and serum P1NP, β- CTX and N-MID levels decreased significantly in the primary osteoporosis group compared with before the treatment (P ＜ 0.05 or 0.01). BMD of lumbar spine (L2, L3, L4, L1-4) and hip (greater trochanter and hip average) increased significantly, and serum P1NP, β-CTX and N-MID levels decreased significantly in the secondary osteoporosis group compared with before the treatment (P ＜ 0.05 or 0.01). Serum N-MID level in the secondary osteoporosis group was significantly lower than that in the primary osteoporosis group after the treatment (P ＜ 0.01). BMD and Serum P1NP, β-CTX, 25(OH) D and PTH levels after the treatment were not significantly deferent between the groups. There were no significant differences in serum Ca, P, BUN and Cr levels before and after the treatment in both groups. No osteoporotic fractures occurred during the treatment course. In the primary osteoporosis group, fever occurred 2 times, and in the secondary osteoporosis group, fever occurred 3 times, indicating that the two groups were not significantly different in the incidence of adverse events. Conclusion In women with osteoporosis of different causes, zoledronic acid can significantly improve the indicators of bone metabolism, inhibit bone loss, increase BMD of lumbar spine and hip, reduce fracture risk, and has few adverse reactions． [ABSTRACT FROM AUTHOR]

Objective To investigate the prevalence of osteoporosis,the changes of bone metabolic biochemical markers,and the related factors in the patients with rheumatoid arthritis( RA). Methods Bone mineral density( BMD) of lumbar spine L1-4 and the proximal femur were measured using dual energy X-ray absorptiometry( DXA) in 110 RA patients( 28 males and 82 females)and 120 normal people( 30 males and 90 females). The bone metabolic biochemical markers,serum procollagen type I amino terminal peptide( NTX-1) and bone alkaline phosphatase( B-ALP),and related clinical indicators were also measured. Results BMD of the lumbar spine in men,premenopausal and postmenopausal women in RA group were lower than that in the control group( P < 0. 05),and it decreased most significantly in postmenopausal women( P < 0. 01). BMD of the hip in osteoporosis patients in RA group( 26 cases,23. 6%) was negatively correlated with disease duration,number of swollen joints,tender joint count,ESR,CRP,and X-ray stage( P < 0. 05),but was not significantly correlated with RF( P > 0. 05). NTX-1 level gradually increased in RA patients in normal bone mass group,osteopenia group,and osteoporosis group,and there were significant differences between any two groups( P < 0. 05). Compared with those in osteoporosis group,the levels of ESR and CRP were significantly decreased in normal bone mass group and osteopenia group( P < 0. 05),but the level of B-ALP was significantly increased( P < 0. 05). There were no significant differences between the normal bone mass group and osteopenia group in the levels of B-ALP,CRP,and ESR.The level of NTX- 1 was positively correlated with the level of CRP( P < 0. 05). Conclusion Osteoporosis in RA is common.Bone metabolic biochemical markers NTX- 1 and B-ALP may be measured as an activity index in the early stage. [ABSTRACT FROM AUTHOR]