接受激素剥夺疗法 (HDT) 的绝经前乳腺癌 (BC) 女性的骨健康管理通常具有挑战性，且骨活性药物的有效性仍不清楚。这项回顾性多中心研究纳入了 306 名接受 HDT 的早期 BC 绝经前女性。 HDT 开始后 12 个月以及至少 24 个月后对骨矿物质密度 (BMD) 和形态测量椎体骨折 (VF) 进行评估。初步评估后，77.5% 的女性服用了骨活性药物（151 狄诺塞麦 60 mg/6月，86 个双磷酸盐）。 47.0 ± 20.1 个月后，16 名女性 (5.2%) 发现了新的 VF。椎骨骨折风险与肥胖（比值比 [OR] 3.87，P = .028）、髋部骨折或室颤家族史（OR 3.21，P = .040）、化疗引起的更年期（OR 6.48，P < .040）显着相关。 001）、先前存在的 VF（OR 25.36，P < .001）、任何骨骼部位的基线 T 分数小于或等于 -2.5 标准差 (SD)（OR 4.14，P = .036）以及腰椎和腰椎的变化髋部总 BMD（分别为 OR 0.94，P = .038 和 OR 0.88，P < .001）与接受骨活性药物治疗的女性相比，未经治疗的女性更容易发生新发 VF（14/69，20.8% vs 2/）。 237，0.8%；P < .001），并且在校正 BMI（OR 0.03；P < .001）、骨折家族史（OR 0.03；P < .001）、化疗引起的更年期后，抗骨折效果仍然显着。 (OR 0.04；P < .001) 和既往存在 VF (OR 0.01；P < .001)。接受 HDT 的绝经前女性发生 VF 的风险较高，这与高 BMI、骨质疏松症的密度诊断、既往存在 VF 和家族史有关骨质疏松性骨折。在这种情况下，双磷酸盐或狄诺塞麦可以有效预防椎骨骨折。© 作者 2024。由牛津大学出版社代表欧洲内分泌学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

Bone health management in premenopausal women with breast cancer (BC) under hormone-deprivation therapies (HDTs) is often challenging, and the effectiveness of bone-active drugs is still unknown.This retrospective multicenter study included 306 premenopausal women with early BC undergoing HDTs. Bone mineral density (BMD) and morphometric vertebral fractures (VFs) were assessed 12 months after HDT initiation and then after at least 24 months.After initial assessment, bone-active drugs were prescribed in 77.5% of women (151 denosumab 60 mg/6 months, 86 bisphosphonates). After 47.0 ± 20.1 months, new VFs were found in 16 women (5.2%). Vertebral fracture risk was significantly associated with obesity (odds ratio [OR] 3.87, P = .028), family history of hip fractures or VFs (OR 3.21, P = .040], chemotherapy-induced menopause (OR 6.48, P < .001), preexisting VFs (OR 25.36, P < .001), baseline T-score less than or equal to -2.5 standard deviation (SD) at any skeletal site (OR 4.14, P = .036), and changes at lumbar and total hip BMD (OR 0.94, P = .038 and OR 0.88, P < .001, respectively). New VFs occurred more frequently in women untreated compared to those treated with bone-active drugs (14/69, 20.8% vs 2/237, 0.8%; P < .001) and the anti-fracture effectiveness remained significant after correction for BMI (OR 0.03; P < .001), family history of fractures (OR 0.03; P < .001), chemotherapy-induced menopause (OR 0.04; P < .001), and preexisting VFs (OR 0.01; P < .001).Premenopausal women under HDTs are at high risk of VFs in relationship with high BMI, densitometric diagnosis of osteoporosis, preexisting VFs, and family history of osteoporotic fractures. Vertebral fractures in this setting might be effectively prevented by bisphosphonates or denosumab.© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.