Analysis of factors affecting increase in bone mineral density at lumbar spine by bisphosphonate treatment in postmenopausal osteoporosis

• Published in: Journal of bone and mineral metabolism 2009-01, Vol.27 (1), p.76-82
• Main Authors: Kaji, Hiroshi, Hisa, Itoko, Inoue, Yoshifumi, Naito, Junko, Sugimoto, Toshitsugu, Kasuga, Masato
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Aged; Aged, 80 and over; Biological and medical sciences; Bone Density; Bone Density Conservation Agents - pharmacology; Bone Density Conservation Agents - therapeutic use; Bones; Bones, joints and connective tissue. Antiinflammatory agents; Diphosphonates - pharmacology; Diphosphonates - therapeutic use; Diseases of the osteoarticular system; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - anatomy & histology; Lumbar Vertebrae - drug effects; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Older people; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - pathology; Osteoporosis. Osteomalacia. Paget disease; Pharmacology. Drug treatments; Radiodiagnosis. Nmr imagery. Nmr spectrometry
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-008-0005-y

Bisphosphonate is an effective drug to reduce fracture risk in osteoporotic patients; however, factors affecting the efficacy of bisphosphonate treatment are not fully known, especially in Japanese patients. In the present study, we examined the relationships between an increase in lumbar spine bone mineral density (BMD) by bisphosphonates and several pretreatment parameters, including biochemical, bone/mineral, and body composition indices, in 85 postmenopausal osteoporotic patients treated with alendronate or risedronate. BMD increase was measured by dual-energy X-ray absorptiometry at the lumbar spine before and 2 years after treatment. BMD increase at the lumbar spine was observed as independent of age, height, weight, body mass index, and fat mass, although lean body mass seemed slightly related. On the other hand, fasting plasma glucose (FPG) levels were significantly and positively related to BMD increase at the lumbar spine. In multiple regression analysis, FPG levels were not significantly related to BMD increase at the lumbar spine when lean body mass was considered. As for bone/mineral parameters, BMD increase at the lumbar spine was not significantly related to serum levels of calcium, parathyroid hormone (PTH), and alkaline phosphatase or urinary levels of deoxypiridinoline and calcium excretion. As for BMD parameters, Z-scores of BMD at any site and bone geometry parameters obtained by forearm peripheral quantitative computed tomography were not significantly related to BMD increase at the lumbar spine. BMD increases at the lumbar spine were similar between groups with or without vertebral fractures. In conclusion, BMD increase at the lumbar spine by bisphosphonate treatment was not related to any pretreatment parameters, including body size, body composition, and bone/mineral metabolism in postmenopausal Japanese women with primary osteoporosis, although FPG correlated partly to BMD through lean body mass.