Changes of bone markers by hypocholesterolemics in postmenopausal osteoporosis

Abstract EN

Introduction: A number of observational studies found a decreased incidence of fractures among patients who take Hydroxymethylglutaryl-CoA reeducates inhibitors, currently known as Statin drugs.

Also, several in vitro and animal studies suggest that statin drugs have an anabolic and antiresorptive effect on bone.

Objective: the aim was to evaluate the effect of using statins alone, versus bisphosphonate alone versus combined statins and bisphosphonate on bone formation and desorption markers.

Methodology : The study comprised 90 females diagnosed as postmenopausal osteoporotic cases.

Their mean age was (age 57 + 3.5 years) with range from 49-62.

There were no other concomitant diseases.

Thirty of them (Group I) received Hydroxymethylglutaryl-CoA reeducates inhibitor (HMG-CoA reeducates inhibitor).

The 2nd group (n = 30) received alendronate sodium.

The third group (n = 30) received both medications.

In all the three groups, we gave supplement calcium (500mg / day) and vitamin D (1ug / day).

The treatment duration continued for 3-5months.

Bone formation and desorption markers were measured before and after treatment.

These include Osteocalcin (OC), bone alkaline phosphatase (BAP), Urinary deoxypyridinoline (UDPD).

Also, 25-hydroxycholecalciferol (25OHvit.D3) and Parathyroid hormone (PTH) were measured.

Bone mineral densitometry (BMD) of the spine (lumbar vertebrae 2–4) and femoral neck (FN) was measured at the start of the study using dual-energy x-ray absorptiometry (DXA).

Results : before starting the treatment, the mean serum values of BAP (u / l) in the three groups (54.7 + 6.8, 57.7 + 7.5, 51.3 + 7.1), of OC (nmol / l) (22.7 + 3.6, 20.7 + 5.3, 22.7+ 3.5) and UDPD(nmol / mmol cr) (20.2 + 4.6, 19.6 + 2.9, 18.5 + 5.4) showed no significant difference between the three groups.

But at the end, there was decrease of bone markers in the three groups; Group III being more (31.7 + 1.4, 13.6 + 0.6 and 5.9 + 0.7) if compared with group II (30.5 + 1.7, 6.0 + 1.1 and 5.2 + 0.8), and the least change was recorded in group I (2.8 + 1.8, 1.8 + 0.8 and 1.6 + 1.1).

Correlation study showed significant positive correlation between the treatment duration and the change (decrease) of the OC (r = +0.61), BAP (r = +0.70) and UDPD (r = +0.55).

There was significant positive correlation between the changes (decrease) in the three parameters (BAP, OC and UDPD).

Conclusion : HMG-CoA reeducates inhibitor has some additive effect in treatment of postmenopausal osteoporosis.

They may stimulate bone formation if it is simultaneously given with the currently used bisphosphonate, calcium and vitamin-D.