The effects of heparin and low molecular weight heparins on bone.
Recent clinical trials have shown that the risk of developing osteoporosis is substantially lower when low molecular weight heparins (LMWHs) are used in place of unfractionated heparin. While the reason(s) for this difference has not been fully elucidated, studies with animals have suggested that heparin causes bone loss by both decreasing bone formation and increasing bone resorption. In contrast, LMWHs appear to cause less bone loss because they only decrease bone formation. Whether all LMWHs decrease bone formation and therefore cause bone loss is unknown. For example, preliminary in vitro studies with the synthetic pentasaccaride, Fondaparinux, have suggested that it may not decrease bone formation and thus, may have no deleterious effects on bone. Further studies are required in order to determine if all LMWHs cause bone loss equally.
Rajgopal
Raghav
R
Department of Pathology and Molecular Medicine, McMaster University and the Henderson Research Centre, Hamilton, Ontario, Canada.
Bear
Mackenzie
M
Butcher
Martin K
MK
Shaughnessy
Stephen G
SG
D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects*; D001842:Bone and Bones / Q000187:drug effects*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced* / Q000503:physiopathology
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight