title: Effect of alendronate on bone mineral density and bone turnover markers in post-gastrectomy osteoporotic patients.
abstract: Alendronate decreases the urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX; about 45% at 3 months) and serum levels of alkaline phosphatase (ALP; about 27% at 24 months), leading to an increase in lumbar spine bone mineral density (BMD; about 9% at 24 months) in postmenopausal Japanese women with osteoporosis. However, the effectiveness of oral bisphosphonates on osteoporosis remains to be established in patients who have undergone a gastrectomy. The objective of the present case series study was to examine the effect of alendronate on BMD and bone turnover markers in post-gastrectomy osteoporotic patients. Sixteen patients (3 men and 13 postmenopausal women) with osteoporosis, who had undergone a gastrectomy (mean age: 69.1 years), were recruited in our outpatient clinic. All the patients were treated with alendronate (5 mg daily or 35 mg weekly) for 24 months. The effects of alendronate on lumbar spine (women) or total hip (men) BMD and urinary NTX and serum ALP levels were examined. A total or partial gastrectomy had been performed for eight patients each. The mean duration after surgery was 16.0 years. With alendronate therapy, urinary NTX levels significantly decreased at 3 months (-27.0%). Serum ALP levels decreased (-12.1%) and lumbar spine BMD increased (+5.2%), but total hip BMD did not significantly change (+0.6%) at 24 months. No severe adverse events were observed, and alendronate therapy was well tolerated. These results suggest that alendronate mildly increases lumbar spine BMD by mildly reducing bone turnover in osteoporotic patients after a gastrectomy.
authors.affiliation: Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. jiwamoto@sc.itc.keio.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Iwamoto
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Uzawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sato
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takeda
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use*; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects*; D001842:Bone and Bones / Q000737:chemistry / Q000000981:diagnostic imaging / Q000187:drug effects; D003094:Collagen / Q000652:urine; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D010352:Patient Dropouts; D011859:Radiography; D012727:Sex Characteristics; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; C461299:urinary N-telopeptide of type I collagen, human; D003094:Collagen; D000469:Alkaline Phosphatase; D019386:Alendronate
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