[Effects of alendronate on bone mineral density, cytokines and indices of bone metabolism in postmenopausal osteoporotic patients].
OBJECTIVE
To observe the effects of alendronate on bone mineral density (BMD), cytokines and indices of bone metabolism in postmenopausal osteoporotic (PMO) patients.


METHODS
185 PMO patients, aged from 55 to 60 years, were randomized into three groups. All of them received a kind of calcium preparation, 1.0 g/d. Group A, 69 patients, received alendronate, 10 mg/d; group B, 66 patients, received tibolone 1.25 mg/d. The remaining patients, group C, received calcium preparation only. 20 women of 55 - 60 (57.4 +/- 3.5) years old were taken as normal controls. Dual-energy X-ray absorptiometry and measurement of a series of biochemical indices were carried out before and after medication at 24th and 48th week.


RESULTS
After medication, BMD increased in alendronate and tibolone group. The increment in spine BMD was 2.53% and 3.65% (P < 0.05) and that in nondominant proximal femur BMD was 7.17% and 3.01% (P < 0.001). In the tibolone group, the levels of estradiol (E(2)) increased rapidly (P < 0.01), but those of IL-6, TNFalpha and type I collagen cross-linked N-telopeptides (NTX) decreased (P < 0.01). In the alendronate group, no change of levels of E(2) happened, while levels of alkaline phosphatase (ALP) and osteocalcin (BGP) increased (P < 0.05) and levels of NTX decreased (P < 0.05). There was no change of the levels of other parameters. In the calcium preparation group and control group, the levels of BMD, E(2), ALP, BGP and insulin-like growth factor I decreased (P < 0.05), while those of IL-6, TNFalpha and NTX increased (P < 0.05).


CONCLUSIONS
Alendronate can significantly improve BMD as tibolone do. Thus it plays an important role in the treatment of osteoporosis. However calcium tablet can not prevent the loss of bone.
Zhang
Xiu-zhen
XZ
Department of Endocrinology, Tongji Hospital of Tongji University, Shanghai 200065, China. xiuzhen45@hotmail.com
Song
Li-ge
LG
Li
Hong
H
Han
Jun-feng
JF
Qian
Guo-feng
GF
He
Ming
M
Li
Ying
Y
Gu
Lei
L
D019386:Alendronate / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D050071:Bone Density Conservation Agents; D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D019386:Alendronate