IZUChENIE PLEYOTROPNYKh EFFEKTOV V-ADRENOBLOKATOROV I INGIBITOROV APF NA KOSTNUYu TKAN'

Abstract

Objective: To investigate the effect of treatment with betablockers (β-AB), inhibitors of angiotensin converting enzyme (ACEI) on bone mineral density (BMD) depending on the risk factors (RF) of osteoporosis. Material and methods. In a retrospective study included 1129 outpatients (1093 women) aged over 40 years, who had the first DXA examination prior to start of the treatment for osteoporosis. Baseline characteristics of pts including data on osteoporosis risk factors (RF) and medication were obtained at the initial visit which had taken place between 2001 and 2011. BMD at the lumbar spine (LS), femoral neck (FN) and total hip (TH) were measured by DXA (Hologic Delphi W). 384 pts have been taking β-AB, ACEI and their combination not less than 6 months before the DXA examination ("users group”), 745 pts. have not been receiving any therapy ("non-users group”). Results. In the "users group” risk of reduction of BMD was lower than in the non-users [RR=1,6 (95 % CI 1.25-2,022) p<0.001], osteoporosis was diagnosed 1,3 times less frequently, and the BMD in LS, FN and TH were significantly higher than these parameters in "non-users group”. The highest BMD were noted in pts on combined therapy. The risk of BMD reduction not depends in both groups on RF such as age, postmenopause duration, presense of early or surgical menopause, low body weight, physical inactivity, previous fractures, fractures in relatives, rheumatoid arthritis, glucocorticoid use or alcohol abuse. In multivariate regression analysis after adjustment with these RF, BMD at all measured locations in users group maintained significantly higher than in non-users. There was no correlation between BMD and duration of β-AB and ACEI therapy. Conclusion Prolonged use of β-AB, ACEI in combination as well as monotherapy could has a protective effect on bone mass regardless of osteoporosis risk factors.

Keywords

• бета-адреноблокаторы
• ингибиторы ангиотензинпревращающего фермента
• минеральная плотность кости
• факторы риска остеопороза